This is a variant of scabies where the skin lesions are extremely massive
and extensive. Thick, grey keratoses and crusts develop on the hands,
elbows, knees and ankle joints and also extend to areas not normally
affected by scabies such as the face and scalp, and nail beds. Norwegian
scabies is seen in severely immunocompromised patients such as in
AIDS patients. The crusts are teeming with scabies mites and thus very
infective to others.
Management of Norwegian scabies
- Treatment is as for scabies though it may need to be prolonged.
- Keratolytics need to be applied to remove the thick crusts: salicylic acid 5-10%
ointment or urea 10% ointment.
- Ivermectine 3-12 mg depending on bodyweight plus sulphur 5-20% ointment.
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