Erythroderma due to iatrogenic immunosuppression: a case of Norwegian scabies

Norwegian scabies is a rare type of scabies characterised by hyperkeratotic and crusted plaques and is usually seen in immunologically and neurologically impaired patients. An elderly female presented to us with erythema and scaling over the body along with thick plaques covered with yellow crusts over the flexor aspects of the wrists and forearm. There was family history suggestive of scabies in other family members. The patient had received multiple injections of triamcinolone and was applying topical ointment containing steroids for tinea corporis. The HIV ELISA was non reactive. A potassium hydroxide mount showed multiple mites, eggs and faecal pellets. A diagnosis of Norwegian scabies was made and patient treated with oral ivermectin and topical permethrin. We present this case to highlight the possibility of this rare cause of erythroderma in a patient who has been receiving corticosteroids.