| Autor: |
Goh LSH; Yong Loo Lin School of Medicine, National University of Singapore, Singapore City, Singapore.; Department of Pediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore City, Singapore., Karthik SV; Department of Pediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore City, Singapore.; Khoo Teck Puat - National University Children's Medical Institute, National University Health System, Singapore City, Singapore., Mohamed Nor NH; Khoo Teck Puat - National University Children's Medical Institute, National University Health System, Singapore City, Singapore.; Department of Pediatric Surgery, National University Hospital, Singapore City, Singapore., Loh DLSK; Department of Pediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore City, Singapore.; Khoo Teck Puat - National University Children's Medical Institute, National University Health System, Singapore City, Singapore., Mali VP; Khoo Teck Puat - National University Children's Medical Institute, National University Health System, Singapore City, Singapore.; Department of Pediatric Surgery, National University Hospital, Singapore City, Singapore. |
| Abstrakt: |
BACKGROUND Crusted scabies is a severe skin infection resulting from hyper-infestation with the obligate parasite Sarcoptes scabiei var. hominis. In contrast to classic scabies, crusted scabies may involve as many as hundreds to millions of mites. Importantly, this condition is associated with a mortality rate of 60% in 5 years, and is more likely to develop in immunosuppressed hosts, presumably due to an impaired T-cell response against the mite. CASE REPORT We present a case of crusted scabies in a 13-year-old girl during her early post-liver transplant period receiving immunosuppression successfully treated with topical 5% permethrin. She had pruritic erythematous papules, confirmed as scabies through skin scraping. The challenge of misdiagnosis during the initial presentation is noteworthy, given atypical manifestations and more common differentials. To our knowledge, only 2 cases of crusted scabies in pediatric solid-organ transplant recipients have been reported. Despite the absence of guidelines for pediatric solid-organ transplant recipients, urgent treatment is required due to the high associated mortality rates. In our case, early treatment proved successful without any secondary bacterial infections or clinical evidence of relapse during a 6-month follow-up. CONCLUSIONS We report a case of scabies in a pediatric liver transplant recipient that was successfully treated. It is crucial to consider the diagnosis of scabies given the associated morbidity and the risk of secondary bacterial infections among other more common differentials. Notably, the response to standard anti-scabies treatment may lead to resolution without relapse in pediatric solid-organ transplant recipients. |
