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Mishaps Leading to Systemic Chemotherapy

Francisca Kartono, BS; Edward W. Lee, MD, PhD; David Lanum, MD; Lien Pham, MD; Howard I. Maibach, MD

Arch Dermatol. 2007;143(5):626-628.

Background  Crusted Norwegian scabies is a rare hyperkeratotic variant of scabies infestation. We report herein a case of crusted scabies in a woman with underlying Langerhans cell histiocytosis (LCH).

Observations  A 49-year-old woman with LCH was hospitalized owing to marked thrombocytopenia. Her hyperkeratotic skin eruption was thought to be secondary to LCH because several years earlier, she had positive biopsy findings and had been diagnosed as having LCH. After a 1-month hospital stay, her laboratory values improved despite worsening of her skin lesions.

Conclusion  Analysis of skin scrapings confirmed the presence of scabies, and resolution was achieved with a 1-dose ivermectin treatment.

Author Affiliations: Western University of Health Sciences, Pomona, Calif (Ms Kartono); Department of Family Medicine, Arrowhead Regional Medical Center, Colton, Calif (Drs Lee, Lanum, and Pham); Department of Radiology, University of California, Los Angeles, UCLA Medical Center, Los Angeles (Dr Lee); and Department of Dermatology, University of California, San Francisco, UCSF Medical Center, San Francisco (Dr Maibach).