@article{6705,
  keywords = {Administration, Oral, Administration, Topical, Adolescent, Adult, Aged, Antiparasitic Agents, Australia, Drug Therapy, Combination, Eosinophilia, Humans, Immunocompromised Host, Immunoglobulin E, Infant, Newborn, Ivermectin, Keratolytic Agents, leprosy, Middle Aged, Review Literature as Topic, Risk Factors, Scabies},
  author = {Roberts L J and Huffam S E and Walton S F and Currie B J},
  title = {Crusted scabies: clinical and immunological findings in seventy-eight patients and a review of the literature.},
  abstract = {<p><b>OBJECTIVES: </b>To describe the clinical and immunological features of crusted scabies in a prospectively ascertained cohort of 78 patients.</p><p><b>METHODS: </b>All patients requiring inpatient treatment for crusted scabies in the 'top end' of the northern territory of Australia over a 10 year period were prospectively identified. Demographics, risk factors, and immunological parameters were retrospectively compiled from their medical records and pathology databases.</p><p><b>RESULTS: </b>More than half the patients with crusted scabies had identifiable immunosuppressive risk factors. Eosinophilia and elevated IgE levels occurred in 58% and 96% of patients, respectively, with median IgE levels 17 times the upper limit of normal. Seventeen percent had a history of leprosy but 42% had no identifiable risk factors. There was a decrease in mortality after the introduction of a treatment protocol consisting of multiple doses of ivermectin combined with topical scabicides and keratolytic therapy.</p><p><b>CONCLUSIONS: </b>Crusted scabies often occurs in patients with identifiable immunosuppressive risk factors. In patients without such risk factors, it is possible that the crusted response to infection results from a tendency to preferentially mount a Th2 response. The treatment regime described was associated with a reduction in mortality. This is the largest reported case series of crusted scabies.</p>},
  year = {2005},
  journal = {The Journal of infection},
  volume = {50},
  pages = {375-81},
  month = {2005 Jun},
  issn = {0163-4453},
  doi = {10.1016/j.jinf.2004.08.033},
  language = {eng},
}