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Crusted scabies pathology

Author: Assoc Prof Patrick Emanuel, Dermatopathologist, Auckland, New Zealand, January 2015.

Table of contents

Crusted scabies (otherwise known as Norwegian scabies) is an uncommon, highly contagious infestation that affects patients with a weakened immune system. The infestation presents with hyperkeratotic plaques with yellowish crusts located on the limbs, trunk, ears and eyebrows.

Histology of crusted scabies

In crusted scabies, there are numerous mites within the stratum corneum. The stratum corneum is markedly thickened and there is epidermal acanthosis (figures 1, 2).

Crusted scabies pathology

Special studies for crusted scabies

None are generally needed.

Differential diagnosis of crusted scabies

Compared with conventional scabies, the mites are far more numerous and associated with hyperkeratosis.



  • Weedon's Skin Pathology (Third edition, 2010). David Weedon
  • Yélamos O, Mir-Bonafé JF, López-Ferrer A, Garcia-Muret MP, Alegre M, Puig L. Crusted (Norwegian) scabies: an under-recognized infestation characterized by an atypical presentation and delayed diagnosis. J Eur Acad Dermatol Venereol. 2014 Nov 26. PubMed 

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