A Case of Norwegian Scabies in a Patient with Chronic Kidney Disease and Down Syndrome

Korean Journal of Nephrology 2010;29(6):813-817.

Gun Woo Kang, M.D.1, Byong-Kyu Kim, M.D.1, Hyo Lim Hong, M.D.1, Ki Hun Chung, M.D.2, Hyun Chung, M.D.2 and In Hee Lee, M.D.1

Department of Internal Medicine1 and Department of Dermatology²
Catholic University of Daegu School of Medicine, Daegu, Korea

증례 : 만성 신질환을 가진 다운 증후군 환자에서 발생한 노르웨이 옴 1예

강건우1, 김병규1, 홍효림1, 정기훈2, 정 현2, 이인희1

대구가톨릭대학교 의과대학 내과학교실1, 피부과학교실2

Abstract

Norwegian or crusted scabies is a rare, highly contagious atypical form of scabies caused by the mite Sarcoptes scabiei var. homonis. It is usually associated with advanced age, immunosuppression, physical debility, and developmental disabilities. We report here a case of Norwegian scabies in an institutionalized patient with chronic kidney disease (CKD) and Down syndrome. A 56-year-old male presented at our department with pruritic rash and general weakness of 2 months' duration. Examination showed hyperkeratotic, scaly, crusted erythematous plaques on the hands, trunk, and back of the patient. The microscopic examination of the skin scales with potassium hydroxide demonstrated numerous scabies mites. The patient was treated with hemodialysis and repeated applications of 1% lindane lotion for 2 weeks. He reported significant relief of pruritus and resolution of the skin lesions after the treatment. In addition to uremic pruritus, infectious skin diseases such as Norwegian scabies should be considered in the institutionalized patients with advanced CKD and resistant pruritus.

Key Words: Chronic kidney failure, Down syndrome, Scabies, Pruritus