What is Crusted Norwegian Scabies?

What is Crusted Norwegian Scabies?

What is Crusted Norwegian Scabies?

Crusted scabies, or Norwegian scabies, is a rare form of scabies caused by an uncontrolled proliferation of mites underneath the skin. Boeck and Danielssen described the effects and appearances of crusted scabies among lepers in Norway in 1848. In 1862, von Hebra named the disease "Scabies Norvegi Boeki." Symptoms of crusted scabies include all the general symptoms of normal scabies, as well as causing hyperkeratosis and crusting of the skin. Other neurologic and immunologic diseases have been reported to predispose crusted scabies.

These mites do not feed on blood, but instead survive on a diet of dissolved human tissue. Mites burrow through the skin daily and will live in their burrows for around 30 days. A person infected with scabies may host an average of 10 to 12 mites on their body. However, those infected with crusted scabies, are infested with an astronomical number of mites because of their uncontrolled proliferation. Mite's antigens that trigger our bodies immune responses are most likely caused by their saliva. A healthy individuals' immune system will reduce the number of mites present, but will not completely eliminate the parasite. Because crusted scabies develops in those with defective T-cells, when a person's immune system fails to combat the mite's infection, they will continue to spread and multiply. Increased levels of interleukin-4 leads to hyperkeratosis of the skin, which is a major symptom of crusted scabies.

Psoriasiform dermatitis may also be present in those infected with crusted scabies, causing crusty, wart-like lesions covering the hands and feet. Rarely does crusted scabies infect the entire body, however, some may localize to the scalp, face, penis, fingers, and soles. A secondary bacterial infection may arise known as Staphylococcus aureus, which can cause even more complications and should be treated immediately. Crusted scabies mimic a number of conditions, including psoriasis, eczema, seborrheic dermatitis, darier's disease, pityriasis rubra pilaris, lichen planus, and cutaneous lymphoma.

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