Indian J Sex Transm Dis Indian J Sex Transm Dis
Official Publication of the Indian Association for the Study of Sexually Transmitted Diseases
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  Table of Contents  
PHOTOFEATURE
Year : 2020  |  Volume : 41  |  Issue : 1  |  Page : 137-138
 

Crusted scabies with scalp involvement in an institutionalized elderly


1 Department of Dermatology, E-Da Cancer Hospital; College of Medicine, I-Shou University, Taiwan
2 Department of Dermatology, Kaohsiung Medical University Hospital; Department of Dermatology, Faculty of Medicine, College of Medicine, Kaohsiung Medical University Kaohsiung, Taiwan

Date of Submission09-Feb-2018
Date of Acceptance09-Jan-2019
Date of Web Publication18-Jun-2020

Correspondence Address:
Dr. Cheng-Che E Lan
No. 100, Tzyou 1st Road, Kaohsiung
Taiwan
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijstd.IJSTD_101_17

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   Abstract 

Scabies is a common disease and typically described as a skin condition with sparing of face and scalp in adults. However, crusted scabies is not conventional scabies. It can also affect the scalp. Herein, we report an unusual case of crusted scabies with scalp infestation and suggest that for cases with suspicious lesions on scalp, immunocompromised patients or relapse cases, crusted scabies, special age groups, such as infant, young children, and the elderly, topical treatment of the scalp should be included.


Keywords: Crusted scabies, Sarcoptes scabiei var. hominis, scabies


How to cite this article:
Chiu HH, Lan CC. Crusted scabies with scalp involvement in an institutionalized elderly. Indian J Sex Transm Dis 2020;41:137-8

How to cite this URL:
Chiu HH, Lan CC. Crusted scabies with scalp involvement in an institutionalized elderly. Indian J Sex Transm Dis [serial online] 2020 [cited 2020 Jul 16];41:137-8. Available from: http://www.ijstd.org/text.asp?2020/41/1/137/286992


A 91-year-old bed-ridden female with diabetes mellitus, stroke, and chronic obstructive pulmonary disease was admitted to the ward of internal medicine department due to sepsis. She is institutionalized to the nursing home. Hyperkeratotic plaque with scales over the occipital scalp without obvious skin lesion on the other site of body, including her face, except scaling lesions over finger webs, was noted [Figure 1]. Skin scrapings from a scalp lesion revealed abundant scabies mites, eggs, and scybala [Figure 2]. The patient was treated with topical scabicide and keratolytic agents. The patient died 2 days after diagnosis. We were not sure if there were any contactants affected in her nursing home.
Figure 1: Hyperkeratotic plaque with scales over the occipital scalp (left) and finger web (right)

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Figure 2: Sarcoptes scabiei var. hominis: Eggs and scybala (left) and mite (right)

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Scabies is typically described as a skin condition sparing face and scalp. Therefore, most guidelines suggest that topical scabicide should be applied from neck down. However, scabies with scalp involvement may be not so rare as once commonly believed. For relapse or debilitated institutionalized patients, topical scabicide should be applied to the scalp as well to ensure the complete eradication of infestation.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.




    Figures

  [Figure 1], [Figure 2]



 

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