To report a case of crusted scabies presenting as erythroderma and review the literature on similar cases to highlight diagnostic challenges and implications.
Approach:
Case Description: A 70-year-old man with a history of psoriasis developed generalized erythroderma with pruritus and crusted plaques. Skin biopsy showed psoriasiform changes, while skin scrapings confirmed Sarcoptes scabiei. Treatment with oral ivermectin and topical scabicidal therapy resulted in marked clinical improvement.
Key Findings:
Crusted scabies is a rare cause of erythroderma, accounting for <0.5% of cases.
Misdiagnosis is common due to clinical overlap with other dermatoses, potentially delaying appropriate treatment.
Effective treatment requires antiparasitic therapy rather than immunosuppression.
Interpretation:
The case underscores the need for careful clinical assessment and parasitological examination in patients with erythroderma.
Limitations:
The literature review may not capture all cases due to publication bias.
The rarity of crusted scabies limits the generalizability of findings, potentially affecting the understanding of its clinical presentation.
Conclusion:
Considering crusted scabies in erythroderma cases can reduce misdiagnosis and improve management.
