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Crusted scabies is a severe and highly contagious form of scabies caused by a weakened immune system, with thousands of mites present on the body. Treatment is difficult due to the thick, flaky skin and large number of mites, but can involve keratolytic agents, scabicidal creams, and antibiotics. It is important to treat close contacts and wash all bedding and clothing to prevent re-infestation.
Although the two types of scabies are both caused by the same parasite, crusted scabies is a much more serious form of the well-known regular scabies and is often more difficult to treat. Scabies is a very itchy rash caused by a skin parasite known as Sarcoptes scabiei or itch mite. This tiny, translucent arthropod burrows under the top layer of skin to lay eggs and is highly contagious. Crusted scabies is also known as Norwegian scabies, as it was discovered in Norway during the mid-1800s.
The main difference between common scabies and crusted scabies is the number of mites present on the host. During a normal scabies infestation, despite intense itching, there are typically between five and 50 mites on the host. A patient with crusted scabies, however, will often have thousands of mites or more on their body at one time.
The large number of mites on an individual with crusted scabies is most likely due to the sufferer’s immune system. These individuals often have compromised or weakened immune systems. Individuals at risk include the elderly, people with physical disabilities, and people diagnosed with HIV or AIDS.
The most commonly reported symptom of scabies is intense itching in certain areas of the body, often worse at night, along with small red bumps. The skin on the affected areas of the body often becomes flaky and begins to flake. Scabies is most often found in the creases of the body, such as between the fingers and toes, in the armpits, and around the groin. In cases of crusted scabies, however, the rash often becomes present all over the body and patches of thick, crusted skin usually begin to form. While there is some itching with crusted scabies, it is often less severe, which is most likely due to the state of the host’s immune system.
Treating crusted scabies is generally much more difficult than treating other types of scabies. This is because it is more difficult for topical creams to penetrate crusted, flaky skin and it is difficult to eradicate the large number of mites present on the body. Dermatologists usually start with an agent that softens and breaks down the top layer of crusty skin found on these patients. These are called keratolytic agents and often contain salicylic acid.
After the top layer of skin has been softened, a topical cream is applied to kill any live mites. Permathrin and lindane are two examples of scabicidal creams. However, lindane is recommended to be used with caution, as it can have some serious side effects, such as neurotoxicity. Ivermectin was first used by doctors to rid patients of certain parasites, but recently dermatologists have started using it to successfully treat scabies patients. Antibiotics can also be used if an infection develops anywhere in the body.
It is important to treat other individuals and areas with which the sufferer has close contact, including other family members, children and significant other people. All bedding and clothing should also be washed and dried thoroughly at high temperatures. Rugs and carpets should be vacuumed well and vacuum cleaner bags should be disposed of immediately. These measures are recommended by dermatologists to prevent any re-infestation of the mites.
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