PDF(Pubmed)
Abstract：
BACKGROUND Crusted scabies is a severe skin infection resulting from hyper-infestation with the obligate parasite Sarcoptes scabiei var. hominis. In contrast to classic scabies, crusted scabies may involve as many as hundreds to millions of mites. Importantly, this condition is associated with a mortality rate of 60% in 5 years, and is more likely to develop in immunosuppressed hosts, presumably due to an impaired T-cell response against the mite. CASE REPORT We present a case of crusted scabies in a 13-year-old girl during her early post-liver transplant period receiving immunosuppression successfully treated with topical 5% permethrin. She had pruritic erythematous papules, confirmed as scabies through skin scraping. The challenge of misdiagnosis during the initial presentation is noteworthy, given atypical manifestations and more common differentials. To our knowledge, only 2 cases of crusted scabies in pediatric solid-organ transplant recipients have been reported. Despite the absence of guidelines for pediatric solid-organ transplant recipients, urgent treatment is required due to the high associated mortality rates. In our case, early treatment proved successful without any secondary bacterial infections or clinical evidence of relapse during a 6-month follow-up. CONCLUSIONS We report a case of scabies in a pediatric liver transplant recipient that was successfully treated. It is crucial to consider the diagnosis of scabies given the associated morbidity and the risk of secondary bacterial infections among other more common differentials. Notably, the response to standard anti-scabies treatment may lead to resolution without relapse in pediatric solid-organ transplant recipients.
摘要：
背景技术结痂疮是一种严重的皮肤感染，由专性寄生虫Sarcoptesscabieivar的过度侵染引起。hominis.与经典的镰刀相反,结痂的sc疮可能涉及多达数百至数百万的螨虫。重要的是,这种情况与5年内60%的死亡率有关，并且更有可能在免疫抑制的宿主中发展，可能是由于对螨的T细胞反应受损。病例报告我们介绍了一例13岁女孩在肝移植后早期接受局部5％氯菊酯成功治疗的免疫抑制治疗期间结痂sc疮的病例。她有瘙痒性红斑丘疹,通过皮肤刮伤确认为sc疮。在初次报告中误诊的挑战是值得注意的，鉴于非典型表现和更常见的差异。据我们所知,据报道，仅有2例小儿实体器官移植受者结痂的sc疮。尽管没有针对小儿实体器官移植受者的指南，由于相关的高死亡率，需要紧急治疗。在我们的案例中,在6个月的随访中,早期治疗被证明是成功的,没有任何继发细菌感染或复发的临床证据.结论我们报告了一例成功治疗的小儿肝移植受者的sc疮。考虑到相关的发病率和继发细菌感染的风险以及其他更常见的差异，考虑sc疮的诊断至关重要。值得注意的是,在接受小儿实体器官移植的患者中,接受标准抗脓肿治疗的应答可能导致病情消退而不会复发.
