Crusted (Norwegian) scabies in a malnourished geriatric patient with dementia

Norwegian scabies, which is a highly contagious variant of scabies, is a common parasitic infestation in elderly persons living in care homes. Clinical symptoms may be different in this patient group (slow onset and insidious progression, often without intense itching) with the addition of comorbid conditions, such as dementia and neurological diseases. Healthcare workers should be aware of this form of scabies, which is more common in elderly and cognitively impaired patients. Early diagnosis can be made easily by a microscopic examination of skin lesions. Isolation precautions are important measures to prevent outbreaks. The treatment includes keratolytic agents besides topical and oral scabicides because of the high mite burden and hyperkeratotic lesions of the crusted scabies. In this study, we reported on a case who had resided in a geriatric care home. The patient was diagnosed with crusted scabies and died in our intensive care unit with pneumonia.