Crusted Scabies Initially Considered as Bullous Pemphigoid and Exacerbated by Steroid Use

Abstract

Crusted or Norwegian scabies is characterized by erythematous patches with diffuse hyperkeratotic plaques over palmar and plantar regions. It is commonly seen in patients with immunocompromised states or in the elderly who are bed-ridden. We report a case of crusted scabies that clinically mimicked bullous pemphigoid. Steroid therapy as treatment of presumptive bullous pemphigoid led to a worsening of crusted scabies and its subsequent outbreak involving patients nearby and staff in our hospital.