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Crusted scabies (also called Norwegian scabies) is an infestation characterized by thick crusts of skin that contain large numbers of scabies mites and eggs. It is a severe form of scabies that occurs most often in people who have a weakened immune system or a neurological disease, the elderly, and the disabled. The symptoms of the more common form of scabies, such as itching and a rash, may be absent. Crusted scabies is very contagious and can spread both by direct skin-to-skin contact and through contaminated items such as clothing, bedding, and furniture. It is caused by super- infestation with Sarcoptes scabiei var hominis, a mite that can only reproduce on humans. People with crusted scabies should receive quick and aggressive medical treatment for their infestation to prevent future outbreaks of scabies. Ivermectin, a drug used to treat parasitic infections, is commonly used for treatment.
Source: GARD Last updated on 05-01-20
Crusted scabies may be particularly difficult to treat. Patients with crusted scabies may be instructed by their doctors to remove scaling skin so that topical medications can penetrate the skin more easily. Repeated applications of a topical medication or combined treatment with a topical and an oral medication for several weeks or longer may be necessary. Patients who still have signs of infection after one month may need additional treatment. Infants and pregnant women should be treated for scabies only if the benefit is determined to outweigh the risk and if the diagnosis is confirmed by biopsy.
A dermatologist or infectious disease physician should be involved in the care of the patient and those with whom they have had close contact. Treatment of crusted scabies should be done in an inpatient or residential setting, with the patient in a private room.Treatment includes oral Ivermectin and topical insecticides.
Last updated on 05-01-20
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