Norwegian Scabies in Two Immune-Compromised Patients: A Case Report

  • Mahmoud RAHDAR Department of Parasitology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
  • Sharif MARAGHI 1. Abadan Arvand International Division, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran 2. Infectious and Tropical Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran 3. Thalassemia and Hemoglobinopathy Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
Keywords: Sarcoptes scabiei; Norwegian scabies; Renal transplant; Diabetes mellitus


Abstract Norwegian scabies (hyperkeratosis scabies) is an acute form of skin disease seen in immune-compromised patients. This study aimed to describe two cases of Norwegian scabies from Ahvaz, southwest of Iran in 2015. Two patients included a 55 year old man with renal transplant history and a 49 yr old man with diabetic mellitus and autoimmune disease, complained of dermatitis lesions and itching with sever hyperkeratosis, several macula and papules on neck and armpits for one-month duration were referred to a Iran Zamin Medical Diagnostic Laboratory in Ahvaz, Southwestern Iran in 2015. Patients were referred for fungal examination. Scraping from the crusted lesions of skin and slide preparation with 20% KOH was done. Microscopic examination presented that huge infestation of Sarcoptes scabiei in all forms of parasite included adult female, nymph stage and eggs. One of the patients spouse was also infested by Sarcoptes and appeared mild clinical symptoms. The disease was diagnosed with Norwegian scabies and the patients were successfully treated with topical 5% permethrin ointment for two weeks continuously. Overall, Norwegian scabies should be considered in immune- compromised patients with contaminated areas.  


1. Rahdar M, Vazirianzadeh B, Maraghi S (2008). A Case Report of Sarcoptes scabiei Infection in Ahvaz, Iran. Iran J Arthropod-Borne Dis, 2 (1): 44- 8.
2. Freites A (2008). [Human T-lymphotropic virus 1 (HTLV-1), strongyloidiasis and scabies. Infections and associations to considerate. Invest Clin, 49 (4): 455- 6.
3. Subramaniam G, Kaliaperumal K, Duraipandian J Rengasamy G (2010). Norwegian scabies in a malnourished young adult: a case report. J Infect Dev Ctries, 4 (5): 349-51.
4. Iwasaki H, Fukushima T, Uchida M et al (1991). [Hospital spread of scabies from an immunocompromised patient with Norwegian scabies]. Kansenshogaku Zasshi, 65 (9):1194-9.
5. Ndiaye B, Develoux M, Dieng MT (1999). [Crusted (Norwegian) scabies in Dakar (Senegal)]. Sante, 9 (4): 243- 8.
6. Yarbrough GK, Iriondo M (1987). Diabetic patient with crusted plaques. Crusted (Norwegian) scabies. Arch Dermatol, 123(6):811, 814.
7. Mehta V, Balachandran C, Monga P et al (2009). Images in clinical practice. Norwegian scabies presenting as erythroderma. Indian J Dermatol Venereol Leprol, 75 (6): 609- 10.
8. Currie BJ, Maguire GP, Wood YK (1995). Ivermectin and crusted (Norwegian) scabies. Med J Aust, 163 (10): 559- 60.
9. Guggisberg D, de Viragh PA, Constantin C et al (1998). Norwegian scabies in a patient with acquired immunodeficiency syndrome. Dermatology, 197 (3): 306- 8.
10. Walton SF, Beroukas D, Roberts-Thomson P et al (2008). New insights into disease pathogenesis in crusted (Norwegian) scabies: the skin immune response in crusted scabies. Br J Dermatol,158 (6):1247- 55.
11. Walton SF HD, Currie BJ, et al (2004). Scabies: new future for a neglected disease. Adv Parasitol, 57:309-76.
How to Cite
RAHDAR M, MARAGHI S. Norwegian Scabies in Two Immune-Compromised Patients: A Case Report. Iran J Public Health. 48(6):1169-1173.
Case Report(s)