Crusted Scabies Mimicking Atopic Dermatitis in an Infant: A Case Report

Crusted scabies is a rare, severe, and highly contagious form of scabies, typically affecting immunocompromised patients. We report an uncommon case in a 7-month-old immunocompetent infant, initially misdiagnosed as atopic dermatitis, leading to prolonged topical corticosteroid use. The patient presented with widespread pruritic erythematous lesions and thick yellowish crusts, in a context of nocturnal pruritus among several family members, and numerous burrows with the characteristic “delta-wing jet” sign upon dermoscopic examination, confirming the diagnosis. Management combined topical benzyl benzoate and weekly permethrin, along with oral ivermectin for household contacts and repeated environmental disinfection, leading to complete resolution.

This case illustrates the risk of misdiagnosis in infants and the role of corticosteroids in precipitating severe forms. Early dermoscopic recognition and comprehensive management are essential to avoid complications and prevent transmission.