02485nas a2200409   4500000000100000008004100001260001300042653002500055653002800080653001500108653001000123653000900133653002500142653001400167653003000181653001700211653001100228653002700239653002100266653002000287653001500307653002300322653001200345653001600357653003100373653001700404653001200421100001600433700001500449700001500464700001500479245011500494300001100609490000700620520143400627022001402061       2005                            d  c2005 Jun10aAdministration, Oral10aAdministration, Topical10aAdolescent10aAdult10aAged10aAntiparasitic Agents10aAustralia10aDrug Therapy, Combination10aEosinophilia10aHumans10aImmunocompromised Host10aImmunoglobulin E10aInfant, Newborn10aIvermectin10aKeratolytic Agents10aleprosy10aMiddle Aged10aReview Literature as Topic10aRisk Factors10aScabies1 aRoberts L J1 aHuffam S E1 aWalton S F1 aCurrie B J00aCrusted scabies: clinical and immunological findings in seventy-eight patients and a review of the literature.  a375-810 v503 a<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>  a0163-4453