BMJ 2011; 342 doi: https://doi.org/10.1136/bmj.d1906 (Published 29 March 2011) Cite this as: BMJ 2011;342:d1906
  1. Kathir Yoganathan, consultant physician ,
  2. Susannah Danino, associate specialist
  1. 1Department of Genitourinary and HIV Medicine, Abertawe Bro Morgannwg University Health Board, Singleton Hospital, Swansea SA2 8QA, UK
  1. kathir.yoganathan{at}wales.nhs.uk

A 36 year old married man presented with a generalised itchy rash on his hands, ears, and scalp. He also had a dry cough with breathlessness. Bronchoscopy confirmed Pneumocystis jirovecii pneumonia. An HIV test was positive. His CD4 count was 23×106/l. His wife and other family members had also had itchy rashes for months. We diagnosed crusted (Norwegian) scabies. He was treated with permethrin and ivermectin. In ordinary scabies in immunocompetent patients, only 10-15 mites are found whereas in crusted scabies thousands of mites are found, and it is highly infectious. Crusted scabies usually occurs in people who are immunocompromised.


Cite this as: BMJ 2011;342:d1906


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