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Crusted Scabies
The combination of itching massive scaling suggests the diagnosis of crusted scabies. This variety of scabies is seen in those who are immunosuppressed or immunocompromised (typically HIV+). Repeated oral doses of ivermectin along with topical permethrin application were required to clear this infestation.
A 40-year-old woman who had been receiving prednisone and azathioprine for the treatment of systemic lupus erythematosus complained of a widespread, intensely pruritic, heavily scaling rash.
Key point: The combination of itching massive scaling suggests the diagnosis of crusted scabies. This variety of scabies is seen in those who are immunosuppressed or immunocompromised (typically HIV+). A mineral oil scraping of the scale should easily demonstrate mites, as it did in this case.
Treatment: Repeated oral doses of ivermectin along with topical permethrin application were required to clear her infestation.
Note: This is highly contagious. All household members should be treated on prophylactic basis.
Common Side Effects of Antiretroviral Therapy in HIV Infection
February 7th 2013What are some of the more common side effects of antiretroviral therapy, and what can the primary care physician do to help manage these effects? In this podcast, infectious disease expert Rodger MacArthur, MD, offers insights and points readers to updated comprehensive guidelines.
