Disseminated crusted scabies in an elderly patient

摘要

A 66-year-old woman was referred to the emergency room for disseminated crusted cutaneous lesions. One year prior, she had presented with pruritus and erythematous papules in the retroauricular area that spread to the scalp, trunk, and limbs. Since the lesions persisted, a skin biopsy was performed three months before admission, and a diagnosis of parapsoriasis was suggested by a clinical physician. The patient was then started on methotrexate (20mg per week) and clobetasol cream. The lesions spread all over the body. Oral methylprednisolone (30mg per day for five days), antihistamines, and cephalexin were also initiated. Despite great improvement in the pruritus, the lesions continued to spread.