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Norwegian scabies after topical administration: case report A 20-year-old man received topical corticosteroids for itching skin lesions and developed Norwegian scabies. The man had begun to experience itching, which was more intense when he went to bed, about 9 months earlier. He had been prescribed mometasone pomade (Elocon), clobetasol ointment (Dermovate) and beclometasone cream and pomade (Beklazon) which he had used at various times, 1–3 times per day [dosages not stated]. He had stopped using the medications for short periods, but when his symptoms worsened again and he had restarted the medications, continuing to use them for about 9 months [durations of treatment not stated for individual preparations]. Examination revealed widespread skincoloured papular lesions on his torso and limbs with some excoriations. He also had plaque-like lesions with silvery hyperkeratotic scales on his elbows, knees, glans penis, and the backs of his hands. Biopsy of a plaque revealed large numbers of Sarcoptes scabiei parasites in his stratum corneum and epidermis. The man was admitted and received a topical pomade containing 7% sulfur. He improved, and after 2 weeks his symptoms had resolved. At 6-month follow-up he had experienced no recurrences. Author comment: We believe that because scabies had not been diagnosed, the patient had initially been given topical steroid treatment which suppressed the pruritis and inflammation giving rise to scabies incognito, which subsequently led to manifestation of Norwegian scabies. Tunca M, et al. Norwegian scabies after use of topical corticosteroid use: Case report. Turkiye Klinikleri Tip Bilimleri Dergisi: Turkish Journal of Medical Science 32: 537-540, No. 2, 5 Mar 2012. Available from: URL: http:// dx.doi.org/10.5336/medsci.2010-16796 [Turkish; summarised from a translation] 803068890 Turkey

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Reactions 7 Apr 2012 No. 1396