Crustose Scabies in a Patient with Down Syndrome: A Clinical Case.

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Abstract
Crusted scabies is a highly contagious form of scabies, most often diagnosed in patients with immunodeficiency, peripheral sensory impairment, and cognitive impairment, especially in residential social service settings. The problem is particularly relevant due to the high risk of nosocomial outbreaks and the spread of infection among contacts and staff of institutions where a patient with crusted scabies is identified. The clinical presentation of the disease is nonspecific, complicating timely diagnosis and complicating its course. A clinical analysis of crusted scabies in a patient with Down syndrome revealed typical manifestations of crusted scabies: mild itching, hyperkeratotic crusts, scalp lesions, and nail changes. The diagnosis of crusted scabies was confirmed by identifying the mite during microscopic examination of a skin scraping and by histological examination of a skin biopsy from the lesion. Treatment consisted of topical antiparasitic and keratolytic agents, as well as a range of preventive measures, which resulted in the patient's recovery. It is important to note that patients at risk for developing crusted scabies include those with immunodeficiency, impaired peripheral sensitivity, drug addiction, long-term use of hormonal and cytostatic drugs, the elderly, and those with significant comorbidities (especially cardiovascular and endocrine diseases). Timely diagnosis and implementation of a full range of medical and non-medical measures to treat scabies and prevent its spread are the foundation of care for this group of patients.

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