Norwegian scabies in a patient with Down syndrome – case report

Abstract

Scabies is a highly infectious dermatosis. It is caused by the mite Sarcoptes scabiei var. hominis. The available estimates indicate more than 400 million cases of scabies annually. The main route of infection is direct skin contact. The main symptoms such as pruritus appear 3–6 weeks after infection. Additionally, papules, erythema, erosions, excoriations, and crusts may be visible. One of the rarest forms of scabies is Norwegian scabies. This is the most severe variant. Its clinical picture may resemble psoriasis. In the article, we present the case of a 21-year-old patient with Down syndrome who was admitted to the department of dermatology with a diagnosis of psoriasis. During hospitalization, due to clinical doubts, it was decided to extend the diagnostics. Basing on the microscopic examination, Norwegian scabies was diagnosed. The treatment involved oral ivermectin and topical 5% permethrin, which resulted in a remission of the skin lesions and the resolution of itching. Key words: Sarcoptes scabiei, Scabies, Crusted scabies, Permethrin, Ivermectin