Norwegian Scabies in a Patient with Down Syndrome

An 11-year-old girl with trisomy 21 and severe atopic dermatitis was admitted for fever of 4  days and nonitchy diffuse thick crusted scaly rash of unknown duration. Prior to the onset of the rash, she had been maintained on topical triamcinolone 1% as treatment for atopic dermatitis. Physical examination revealed elevated temperature (38.7°C), tachycardia (127 beats per minute), diffuse dry hyperkeratotic crusts (Figure, A and B), and areas of skin tenderness and erythema (Figure, B [arrow]). The rest of the examination was unremarkable.
Source: The Journal of Pediatrics - Category: Pediatrics Authors: Tags: Rediscovering the Physical Exam Source Type: research