Scabies in AIDS

Human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) will be the most common disease triggering crusted (Norwegian) scabies. Scabies should be suspected in any atypical itching (or non) rash in HIV/AIDS patients. Attempt to prove the diagnosis by doing a skin scraping, or if negative, a skin biopsy. Unusual forms of scabies in HIV/AIDS can be divided into crusted scabies and atypical (exaggerated) scabies. Therapy requires the sequential use of scabicides, usually over a longer period than is required to clear an ordinary case of scabies. Compliance is a concern, and the scabicides are best administered under supervision whenever possible. Isolating the index patient and treating the environment of patients with crusted or atypical scabies is much more significant than in ordinary scabies. The transmission in hospitals of ordinary scabies from an index patient with crusted scabies to other patients, health care workers, etc, is common. Protective measures and early diagnosis and therapy are essential.