Crusted scabies in systemic lupus erythematosus: More than a mite contagious case

Crusted scabies is characterized by hyperkeratosis and crusting of the skin due to the profuse proliferation of mites. It is resulting from an altered host response to the infestation. There are some various cutaneous and immunologic diseases that have been described to predispose to crusted scabies. It is typically associated with congenital and acquired immunocompromised conditions including human immunodeficiency virus (HIV), hematologic malignancy, and connective tissue diseases, including systemic lupus erythematosus (SLE). Adults with crusted scabies may lack the characteristic rash or itching. Sites of presentation have been reported on the scalp, face, neck, extremities, trunk, hands, and feet. The severe condition of SLE and super infection of scabies in the immunocompromised state highlight the need for appropriate care to avoid further morbidity. This case report aims to describe the characteristic of skin lesions and clinical aspects of crusted scabies in SLE. A 28-year-old man was diagnosed with crusted scabies who was treated more intensely with permethrin 5% cream that was combined with 2-4 ointment. There was clinical improvement and no side effect found during this study.