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Crusted Scabies

What is Crusted Scabies?

Crusted scabies is a severe and contagious variant of scabies. The disease is characterized by the uncontrollable proliferation of the mite that causes the scabies. This variant of scabies is distinctive from the regular scabies wherein the human skin is infected with millions of mites as these mites literally reproduced in the skin.

Crusted scabies is also referred to as “Norwegian scabies” which was so called due to the outbreak that occurred in Norway during the year 1800. The disease was first recognized by the two physicians named Dr. Danielssen and Dr. Boeck who both recognized the disease among lepers. The name Norwegian scabies has nothing to do with the disease except that the outbreak was first recognized in the country. It is now an outdated name and the disease is now referred to as Crusted Scabies.

Crusted scabies is a highly contagious disease and is marked by crusted lesions. It usually affects people who are immunocompromised and those who have weakened immune system due to an existing condition.

The infestation of the mite that causes the crusted scabies often takes a portion of the body where it will proliferate dramatically. The web space between the fingers and the toes, the areas under the arms and groin are the usual place for infestation of the mite where it will continuously reproduce.

The regular scabies usually has a dozen or more of scabies that will invade the body at the same time whereas in crusted scabies, millions of the same mites that caused the regular scabies will take infest the body. The contagious property of crusted scabies is not the only issue but also the secondary infections. The affected person is more prone to secondary infections when their skin is left vulnerable due to incessant scratching and break from the skin as the result of crusting.

Crusted Scabies Symptoms

The classical scabies is hallmarked by the presence of itching but in crusted scabies which is a variant of classic scabies, no itching is usually present or it may be minimal in case there is itchiness. Crusted scabies has no acute eruption but is rather gradual in onset and the progression is rather insidious. The onset of symptoms usually takes about 3 to 6 weeks from the time of infestation.

It is rare for crusted scabies to cover the entire body. The onset is usually limited to the scalp, face, finger, sole of the foot and genitalia. The appearance of the scabies may be horny plaques or may be erythematous. The plaque is often parakeratotic crust with varying thickness of about 3mm to 15mm. Crusted scabies has a porous appearance when the crusts are removed. When the crusts are also removed, it will reveal the undersurface which rather has a smooth texture, moist and reddish in color.

Crusted scabies appears in multiple layers of skin that are rather thick and crusty. It is generally an unsightly appearance that the self-esteem of the patient is usually compromised due to significant embarrassment brought by the unappealing appearance of the crust.

Itchiness is often not present in crusted scabies or may be minimal despite the fact that millions of mites have infested the skin. This is what makes crusted scabies different from the classic scabies which is generally noted with itchiness. The formation of the crust may also result to deformities of the affected area of the body such as the fingers and the toes. The skin on the face may also flake off in crusted scabies while significant hair loss may also occur. Crusted scabies may also be in the form of psoriasis dermatitis or may assume a wart-like appearance. The finger nails are usually discolored and thickened while the nails may have subungual hyperkeratosis.

Crusted scabies respond to treatment gradually unlike the classic scabies. The disease may or may not respond well to treatment that it is sometimes treated in combination with other methods of treatment.

Crusted Scabies Pictures

Photos, Images and Pictures collection of Crusted Scabies…

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Crusted Scabies Causes

People at risk for crusted scabies are the elderly, people who have poor immune system and neurologic diseases and those with mental incompetence. HIV or AIDS patients are also prone to acquire crusted scabies.

Crusted scabies is an extremely contagious variant of scabies. The disease can be transmitted via direct or non-direct contact with the affected individual. Close body contact such as hugging and sexual contact with an infected person is a direct transmission of the disease. Sharing of personal belongings is also included in the direct method of transmitting the harmful pathogen that causes the crusted scabies.

Crusted scabies is generally implicated on the infestation of a certain mite which is the same mite that causes the classic scabies. Sarcoptes scabiei var hominis is an obligate parasite that thrives in the stratum corneum. The main perpetrator of crusted scabies is the female mite that burrows in the surface of the skin. The mite has a rounded body with a length of approximately 400 microns. It has 4 legs with the front composed of two pairs of antenna or suckers. The mite can survive for 30 days in the burrows and feeds on melted human tissues. 2 to 3 eggs are being laid by the female mite daily and which usually takes 3 to 4 days before the eggs can hatch. In crusted scabies, the number of mite increases drastically as a result of uncontrolled proliferation.

It is believed that the antigen of the mite that stimulates the immune response is contained in the saliva of the mite. When a person is immunocompromised, it cannot control the proliferation of the mite thus, the development of crusted scabies.

Crusted Scabies Treatment

The primary aim of treatment of crusted scabies is to isolate the patient to control or prevent the spread of the disease which might result in an outbreak. Necessary and adequate precautions should be done by people who are in contact with the patient including the medical staff who will attend to the patient.

Treatment of crusted scabies has been difficult, often due to the present status of the immune system of the patient.

Topical Medication

Various topical medications can be used to effectively treat the scabies. Topical scabicidals is the preferred treatment although removal of the crusted skin is necessary to allow the medication to seep in and to bring down the number of the mites.


Broad spectrum antibiotics are indicated for crusted scabies with secondary infection especially those associated with septicemia. Another form of treatment for crusted scabies is directed towards the relief of symptoms such as dry skin and itchiness.

Ivermectin is the drug of choice for crusted scabies in the aim of eliminating the mite in the body. This drug is taken orally and acts highly against the mite although it is safe in human. Ivermectin is also used in combination with other scabicidal to effectively eliminate the mite while effectively treating the patient.

Crusted Scabies
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