Case Number : Case 2960 - 10 November 2021 Posted By: Dr. Hafeez Diwan

Crusted scabies!

i agree looks like scabies

Yes, I'm sure this is scabies. 

Whether to call it crusted scabies depends on from where the biopsy was taken.  In Norwegian, crusted scabies, most crusting occurs on the hands and feet, with numerous scabies burrows arising elsewhere on sites not normally affected by "normal" scabies.  This biopsy doesn't show any significant crusting which might just be anatomical variation.  There is background psoriasiform epidermal hyperplasia and underlying inflammation, which I suspect are manifestations of the underlying ichthyosis, possibly non-bullous ichthyosiform erythroderma, now aggravated by scabies.

13 hours ago, Richard Logan said:

Yes, I'm sure this is scabies. 

Whether to call it crusted scabies depends on from where the biopsy was taken.  In Norwegian, crusted scabies, most crusting occurs on the hands and feet, with numerous scabies burrows arising elsewhere on sites not normally affected by "normal" scabies.  This biopsy doesn't show any significant crusting which might just be anatomical variation.  There is background psoriasiform epidermal hyperplasia and underlying inflammation, which I suspect are manifestations of the underlying ichthyosis, possibly non-bullous ichthyosiform erythroderma, now aggravated by scabies.

Agree

scabies and Psoriasiform epidermal hyperplasia

Agree. 

Scabies