Norwegian scabies seen at the University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu State: a case report

Abstract

Norwegian scabies, also known as crusted scabies, is a severe form of scabies caused by an infestation of the skin by the Sarcoptes scabiei var. hominis mite. It is usually diagnostically challenging because of its rare nature and the potential for misdiagnosis with other skin diseases. This case report presents a rare case of Norwegian scabies seen at the University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu State. The patient, a 16-year-old male Human Immunodeficiency Virus (HIV) positive patient, diagnosed with HIV 2 years before presentation but was not adherent to his Anti-retroviral medications, presented with extensive crusted lesions covering the entire body. CD4 + count on admission was 54 cells/mm3 and the viral load was 604 copies/ml and the initial clinical diagnosis was seborrheic hyperkeratosis. The diagnosis was eventually confirmed through skin scrapings and microscopic examination. The patient was then treated with oral ivermectin, topical scabicidal agents, antibiotics, antihistamines, and emollients, with complete clearance of lesions noted after two weeks of treatment. This case highlights the importance of recognizing and promptly treating this apparently rare and diagnostically challenging skin condition in Nigeria.