SKABIES NORWEGIAN PADA ANAK DENGAN LUPUS NEFRITIS

Abstract

Introduction: Norwegian (crusted) scabies is one of the classic infectious variants of scabies. This variant is common in immunocompromised patients including autoimmune diseases who are taking long-term steroids. Method:We report a case  of Norwegian  scabies  in  a  child  with  lupus  nephritis.Case:A  15-year-old  boy,  weighing  40  kg  with  the  chief complaint  of  black-red  spots  and  thick  scales  on  both  fingers,  pubic,  armpit  and  body  accompanied  by  itching especially at night. Complaints of night itching were also felt by the patient's mother. The patient had a history of lupus nephritis who was treated with long-term steroids. The results of microscopic examination of skin scrapings found adult mites,  eggs  and  Sarcoptes  scabiei  schibala.  The  diagnosis  of  Norwegian  scabies  is  based  on  anamnesis,  physical  and microscopic examination. Results: he patient was treated with 5% permethrin cream, 2-4 ointment 2x a day, cetirizine 1 x  10  mg  per  day  for  2  weeks  and  education  on  maintaining  personal  and  environmental  hygiene  gave  healing  to  the patient. Conclusion: Norwegian  scabies  therapy  is  a  combination  of  topical  scabidal  agents,  keratolytic  agents  to facilitate   drug   penetration   and   antihistamines   to   reduce   nocturnal   pruritus   and   education   provides   clinical improvement and prevents recurrence.