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Crusted Scabies — RACP Paediatrics MCQ

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ModerateInfectious DiseaseCrusted ScabiesRACP Paediatrics

A 6-year-old Aboriginal child has crusted scabies. He has thick hyperkeratotic crusts on his hands and feet with generalised excoriation. What makes crusted scabies different from typical scabies in terms of infectivity?

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Correct answer: B — Extremely infectious due to massive mite burden (thousands vs 10-15 in typical scabies)

Crusted (Norwegian) scabies has a massive mite burden (thousands-millions vs 10-15 in typical scabies), making it extremely infectious. It requires combination oral ivermectin + topical permethrin, with repeated doses. Isolation, environmental decontamination, and treatment of all contacts are essential.

Reference: NHMRC – 2024 – Skin Health in Remote Aboriginal Communities