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      Norwegian Scabies in a 70-Year-Old Renal Transplant Recipient: A Case Report

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          Abstract

          Crusted scabies (CS) is an extremely contagious variant of classical scabies with substantial morbidity and mortality. It is the most prevalent in immunocompromised patients, those with some underlying diseases, and individuals with physical and mental disabilities. Herein, we report a 70-year-old woman who presented with generalized erythema with itchy hyperkeratotic plaques and crusted lesions on her face, hands, between fingers, neck, scalp, abdomen, and legs up to the knees. She was diagnosed with CS and subsequently isolated and treated with ivermectin (200 μg/kg) and 5% permethrin cream. She died a short time after being admitted, and it was due to severe septic shock and cardiac arrest. Immediate isolation and treatment of CS patients is essential to prevent morbidity and mortality. Prompt diagnosis and precise medical management in both patients and healthcare settings is required.

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          The public health control of scabies: priorities for research and action

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            Control Strategies for Scabies

            Scabies is a neglected tropical disease of the skin, causing severe itching and stigmatizing skin lesions. Further, scabies leads to impetigo, severe bacterial infections, and post-infectious complications. Around 200 million people are affected, particularly among disadvantaged populations living in crowded conditions in tropical areas. After almost 50 years, research into scabies control has shown great promise, particularly in highly-endemic island settings, but these findings have not been widely adopted. Newer approaches, utilizing ivermectin-based mass drug administration, appear feasible and highly effective. Inclusion of scabies in the WHO portfolio of neglected tropical diseases in 2017 may facilitate renewed opportunities and momentum toward global control. However, further operational research is needed to develop evidence-based strategies for control in a range of settings, and monitor their impact. Several enabling factors are required for successful implementation, including availability of affordable drug supply. Integration with existing health programs may provide a cost-effective approach to control.
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              Crusted scabies.

              Crusted scabies is a rare manifestation of scabies characterized by uncontrolled proliferation of mites in the skin. In immunocompromised patients, this infestation is characterized by crusted lesions. The occurrence of the disease in human immunodeficiency virus-infected patients and the widespread use of immunosuppressive agents has led to a renewed interest in the disease. Early recognition and treatment is necessary to avoid an outbreak of scabies. This review highlights the pathogenesis, predisposing factors, clinical features and treatment of crusted scabies.
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                Author and article information

                Journal
                Iran J Parasitol
                Iran J Parasitol
                IJPA
                Iranian Journal of Parasitology
                Tehran University of Medical Sciences
                1735-7020
                2008-238X
                Apr-Jun 2023
                : 18
                : 2
                : 257-261
                Affiliations
                [1. ] Medical Microbiology Research Center, Qazvin University of Medical Sciences, Qazvin, Iran
                [2. ] Metabolic Diseases Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
                Author notes
                [* ] Correspondence Email: badri22.milad@ 123456gmail.com
                Article
                IJPA-18-257
                10.18502/ijpa.v18i2.13193
                10423906
                f72f945b-4de2-4a4b-ba6a-66bb6af3dabe
                Copyright © 2023 Vafae Eslahi et al. Published by Tehran University of Medical Sciences.

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International license ( https://creativecommons.org/licenses/by-nc/4.0/). Non-commercial uses of the work are permitted, provided the original work is properly cited.

                History
                : 20 November 2022
                : 18 February 2023
                Categories
                Case Report

                Parasitology
                crusted scabies,kidney transplant,septic shock
                Parasitology
                crusted scabies, kidney transplant, septic shock

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