Norwegian or Crusted Scabies is an extremely contagious hyperinfestation with Sarcoptes Scabiei. It is frequently misdiagnosed as psoriasis or seborrheic dermatitis by medical personnel that are…unaware. It is estimated that individuals with Norwegian Scabies have up to 4,000 mites per gram of skin…often infected with over a million mites. This compares with more typical scabies where patients may have between 10-20 mites.
It is most often found in severely debilitated patients. Factors which may contribute to developing this form of scabies includes increased age, dementia, Down syndrome, HIV disease, leprosy, lymphoma, systemic lupus erythematosus (SLE), long-term immunsupressant use (steroids for example) or institutionalized individuals. Scrapings of these patients demonstrate numerous mites, ova and feces…it is not a hard diagnosis to make on a scraping.
TREATMENT: Is the same as that for regular scabies, as shown HERE and HERE. To read more about Norwegian (Crusted) Scabies please click HERE. Due to the massive mite load oral ivermectin is highly recommended. Deaths due to untreated Norwegian scabies have been reported but are very rare. Usually it is related to development of secondary infections and sepsis. A 93 year-old-female in a Georgia nursing home died from scabies in 2015. Local news stations reported that she was “eaten alive by scabies” which is not the case. To read more about this patient click HERE.