Discussion Scabies occurs secondary to infection with Sarcoptes scabiei var hominis, a
parasite that lives and burrows tunnels in the skin. Crusted (Norwegian) scabies is a severe
form of scabies that occurs when the host immune system fails to control mite proliferation,
resulting in hyperinfestation. 1 The large quantity of mites triggers an inflammatory and
hyperkeratotic reaction in the epidermis. Typical clinical features include erythematous
patches that quickly evolve into 3-to 15-mm thick gray or tan crusts. Crusts are most …