Оn the issue of diagnosis of Norwegian scabies on the example of a clinical case

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Norwegian scabies is a rare form of a fairly common contagious skin disease. It is characterized by difficulties in diagnosis due to the absence of a typical clinical picture and characteristic complaints of the patient. Also, the diagnosis of Norwegian scabies is often complicated by the presence of concomitant diseases, such as ichthyosis and mental retardation. As a result of impaired cognitive functions in patients, it is quite problematic to collect complaints and anamnesis. An incorrect diagnosis leads to the appointment of ineffective therapy and, as a result, to further progression of the disease, accompanied by the addition of secondary infection and deterioration of the general condition of the patient’s body.

Training of doctors of various specialties (dermatovenerologists, therapists and general practitioners) in the skills of differential diagnosis of Norwegian scabies is relevant due to the increase in cases of this disease in various groups of people, mainly related to boarding houses and long-stay hospitals.

In this article, the authors provide an overview of the etiology, pathogenesis, and clinical manifestations of a rare form of scabies ― Norwegian scabies, and highlight the difficulties of differential diagnosis of this dermatosis. A clinical case of Norwegian scabies in a 52-year-old woman suffering from ichthyosis and mental retardation on the background of Down syndrome is described.

作者简介

Yulia Karacheva

Professor V.F. Voino-Yasenetsky Krasnoyarsk State Medical University

编辑信件的主要联系方式.
Email: julkar19@yandex.ru
ORCID iD: 0000-0002-7025-6824
SPIN 代码: 4789-9178

MD, Dr. Sci. (Med.)

俄罗斯联邦, Krasnoyarsk

Anastasiya Smykova

Professor V.F. Voino-Yasenetsky Krasnoyarsk State Medical University

Email: smykova.a@mail.ru
ORCID iD: 0000-0001-5846-4244
SPIN 代码: 2226-9685

MD, Cand. Sci. (Med.), Associate Professor

俄罗斯联邦, Krasnoyarsk

Anastasiya Zeib

Krasnoyarsk Regional Dermatovenerologic Dispensary № 1

Email: kristalmed@yandex.ru
ORCID iD: 0000-0001-8480-1427

MD

俄罗斯联邦, Krasnoyarsk

Yana Kovaleva

Professor V.F. Voino-Yasenetsky Krasnoyarsk State Medical University

Email: yanka-kovalevaa@mail.ru
ORCID iD: 0000-0003-3056-4395

Student

俄罗斯联邦, Krasnoyarsk

Anastasiya Yunevich

Professor V.F. Voino-Yasenetsky Krasnoyarsk State Medical University

Email: nastya_unevich@mail.ru
ORCID iD: 0000-0001-7821-6176

Student

俄罗斯联邦, Krasnoyarsk

参考

  1. Salavastru CM, Chosidow O, Boffa MJ, et al. European guideline for the management of scabies. J Eur Acad Dermatol Venereol. 2017;31(8):1248–1253. doi: 10.1111/jdv.14351
  2. Federal clinical guidelines. Dermatovenerology-2015: Skin diseases. Sexually transmitted infections. 5th ed., reprint. and add. Moscow: Business Express; 2016. 768 р. (In Russ).
  3. Sokolova TV, Malyarchuk AP, Yeltsova NV, et al. Norwegian scabies: the realities of our time. Clin Dermatol Venereol. 2020;19(1):64–74. (In Russ). doi: 10.17116/klinderma20201901164
  4. Malyarchuk AP, Sokolova TV, Lopatina YV, Kiseleva AV. Incidence of scabies and other dermatoses in children’s socially significant collective. Russ J Skin Venereal Diseases. 2011;(4):27–32. (In Russ).
  5. Das A, Bar C, Patra A. Norwegian scabies: rare cause of erythroderma. Indian Dermatol Online J. 2015;6(1):52–54. doi: 10.4103/2229-5178.148951
  6. Matsuura H, Senoo A, Saito M, Fujimoto Y. Norwegian scabies. Cleveland Clinic J Med. 2019;86(3):163–164. doi: 10.3949/ccjm.86a.18081

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2. Fig. 1. Patient Yu., 52 years old. On the skin of the trunk and the anterior surface of the neck against the background of erythema ― massive, multi-tiered dense crusts in the form of a horny shell and deep cracks with serous-purulent discharge.

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3. Fig. 2. The same patient. On the skin of the back surface of the hands, against the background of erythema, massive, multi-tiered dense crusts in the form of a horny shell and deep cracks with serous-purulent discharge.

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4. Fig. 3. The same patient after the therapy: against the background of slight erythema, secondary spots, small-lamellar peeling.

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版权所有 © Karacheva Y.V., Smykova A.N., Zeib A.V., Kovaleva Y.A., Yunevich A.S., 2022

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