Scabies with a crusty appearance: Understanding its characteristics, signs, treatments, and additional information
Article Title: Understanding Crusted Scabies: A Severe Form of the Common Skin Condition
Crusted scabies, also known as Norwegian scabies, is a severe infestation of scabies mites and eggs in the skin. This highly contagious form of the common skin condition is characterized by thick crusts of skin containing large numbers of mites.
Who is at Risk?
Crusted scabies most commonly occurs in immunocompromised individuals and people living in overcrowded or institutional settings, where transmission risk and mite burden are high. Immunosuppressive conditions, such as HIV/AIDS, organ transplant recipients on immunosuppressive drugs, those receiving chemotherapy, or people with other disorders causing immunosuppression, significantly increase the risk of developing crusted scabies.
Living in crowded or institutional settings, like nursing homes, military barracks, dormitories, and care facilities, also facilitates transmission due to close and prolonged skin-to-skin contact and shared personal items. Age extremes, chronic illness or neurological conditions, poor socioeconomic conditions, and certain neurological disorders can also predispose individuals to crusted scabies.
Identifying and Diagnosing Crusted Scabies
Early signs of crusted scabies include red patches on the skin that lack a defined edge, which later develop into thick plaques. Doctors may use reflectance confocal microscopy (RCM) or a biopsy to diagnose crusted scabies, particularly in infants and pregnant individuals.
People with crusted scabies may not experience itching or a rash, unlike those with regular scabies. However, common areas where crusted scabies may appear on the body are between the fingers, underneath the nails or in the nail beds, spread over the palms of the hands and soles of the feet, elbows, and knees.
Treatment and Prevention
Treatment for crusted scabies may include oral Ivermectin and topical insecticides such as Permethrin, benzyl benzoate, or Crotamiton. In some cases, treatment may require hospitalization or care in a private room to avoid spreading the condition to others.
People living in institutions or those with a weakened immune system may be at higher risk of reinfestation. Education about crusted scabies and regular follow-ups are important in helping to prevent reinfestation. Keratolytic creams like 5-10% salicylic acid in sorbolene cream or 5% lactic acid and 10% urea in sorbolene cream may be used to soften thick, scaly plaques before applying treatments.
In summary, understanding crusted scabies and its risk factors is crucial in preventing its spread and ensuring timely and effective treatment. By recognising the signs, identifying high-risk populations, and implementing preventative measures, we can help control the spread of this severe form of scabies.
[1] Centers for Disease Control and Prevention. (2021). Crusted Scabies. Retrieved from https://www.cdc.gov/parasites/scabies/diseases/crusted/index.html [2] World Health Organization. (2018). Crusted scabies. Retrieved from https://www.who.int/news-room/fact-sheets/detail/crusted-scabies [3] National Institutes of Health. (2021). Crusted Scabies. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK532926/ [4] American Academy of Dermatology. (2021). Crusted Scabies. Retrieved from https://www.aad.org/public/diseases/contagious-skin-conditions/crusted-scabies
- Other skin conditions, such as HIV/AIDS, organ transplantation, chemotherapy, or neurological disorders that compromise the immune system, can increase the risk of developing crusted scabies.
- Dermatology plays a crucial role in identifying and diagnosing crusted scabies, using tools like reflectance confocal microscopy or biopsies, particularly in infants, pregnant individuals, or those who may not exhibit traditional symptoms.
- Proper skin care, including the use of keratolytic creams to soften thick, scaly plaques before applying treatments, can aid in managing crusted scabies and prevent its reinfestation in high-risk populations like individuals in institutions or those with weakened immune systems.
- In the field of health and wellness, understanding skin conditions like crusted scabies is essential to ensure timely and effective treatment, as well as implementing preventative measures to control its spread.
- Medical research and science contribute significantly to the knowledge of skin-related medical conditions, such as crusted scabies, and their management, providing valuable resources through organizations like the Centers for Disease Control and Prevention, World Health Organization, National Institutes of Health, and American Academy of Dermatology.
