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Crusted scabies pathology

Author: Assoc Prof Patrick Emanuel, Dermatopathologist, Auckland, New Zealand, January 2015.

Crusted scabies (otherwise known as Norwegian scabies) is an uncommon, highly contagious infestation that affects patients with a weakened immune system. The infestation presents with hyperkeratotic plaques with yellowish crusts located on the limbs, trunk, ears and eyebrows.

Histology of crusted scabies

In crusted scabies, there are numerous mites within the stratum corneum. The stratum corneum is markedly thickened and there is epidermal acanthosis (figures 1, 2).

Special studies for crusted scabies

None are generally needed.

Differential diagnosis of crusted scabies

Compared with conventional scabies, the mites are far more numerous and associated with hyperkeratosis.

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