title: Atypically distributed cutaneous lesions of Norwegian scabies in an HIV-positive man in South India: a case report.
abstract: BACKGROUND
  Immune-compromised subjects, especially those with underlying HIV disease, are prone to be infected with Norwegian scabies, where the cutaneous lesions are classically distributed over the extremities.
  
  
  METHODS
  We report the case of an HIV-positive 16-year-old man with severe crusted Norwegian scabies initially misdiagnosed as a dermal fungal infection. The patient had extensive, generalized, thick, hyperkeratotic, crusting, yellowish papule lesions distributed on the entire body from his scalp to his toes.The patient was started with Ivermectin and topical Permethrin, which eventually resulted in complete resolution. Interestingly, despite quarantining efforts, one of the patient's acquaintances and a healthcare worker acquired the symptoms of itching.
  
  
  CONCLUSIONS
  This atypical presentation of Norwegian scabies emphasizes the need to include scabies in the differential diagnosis when HIV-infected patients present with crusted, generalized cutaneous lesions.
authors.affiliation: Infectious Diseases Laboratory, YRG Centre for AIDS Research and Education, VHS Campus, Rajiv Gandhi Salai, Taramani, Chennai, India. vignesh@yrgcare.org
authors.forename: Vignesh
authors.initials: V
authors.lastname: Ramachandran
authors.forename: Esaki Muthu
authors.initials: EM
authors.lastname: Shankar
authors.forename: Bella
authors.initials: B
authors.lastname: Devaleenal
authors.forename: Balakrishnan
authors.initials: B
authors.lastname: Pachamuthu
authors.forename: Shieh Mark
authors.initials: SM
authors.lastname: Thousen
authors.forename: Ramalingam
authors.initials: R
authors.lastname: Sekar
authors.forename: Solomon
authors.initials: S
authors.lastname: Suniti
authors.forename: Kumarasamy
authors.initials: K
authors.lastname: Nagalingeswaran