PP325 : A VERY RARE PRESENTATION OF CRUSTED(NORWEGIAN) SCABIES INVOLVING EYELIDS & CONJUNCTIVA.

Dr.HARSH VARDHAN SINGH

INTRODUCTION: CRUSTED SCABIES IS A RARE & SEVERE VARIANT OF SCABIES CHARACTERISED BY HYPERKERATOSIS & CRUSTING OF SKIN DUE TO PROFUSE PROLIFERATION OF MITES AND ALTERED HOST RESPONSE TO INFESTATION.IT IS USUALLY ASSOCIATED WITH SEVERE MALNUTRITION, IMMUNE DEFICIENT STATE, MENTAL RETARDATION OR DIABETES MELLITUS.

CASE: A 10 YEAR OLD SEVERELY MALNOURISHED BOY PRESENTED IN OUR OPD WITH MULTIPLE CRUSTED LESIONS INVOLVING BOTH EYES, PALMS, SOLES,ELBOWS, NECK & SHOULDER. ON OCULAR EXAMINATION THERE WERE MULTIPLE MACULAR PAPULAR EROSIONS WITH SEVERE HYPERKERATOTIC CRUSTING LESIONS INVOLVING BOTH UPPER & LOWER LIDS WITH ASSOCIATED MADAROSIS (OU). A PIGMENTED CONJUNCTIVAL LESION WAS NOTED IN RIGHT EYE, PART OF WHICH WAS SENT FOR MICROBIOLOGICAL STUDY. THE MICROSCOPIC SLIDE SHOWED TYPICAL PICTURE OF SARCOPTES SCABEI.

RESULT: THE PATIENT WAS MANAGED VIGOROUSLY ALONG WITH DERMATOLOGICAL CONSULTANCY. HE RECOVERED DRASTICALLY WITHIN FEW WEEKS & REPEAT MICROBIOLOGY REPORT WAS NEGATIVE.