The association of crusted scabies with T-lymphotropic virus type I and adult T-cell leukaemia/lymphoma - abstract

ABSTRACT

Crusted scabies is a hyperinfestation with the mite Sarcoptes scabei var Hominis and is characterized by hyperkeratotic plaques and crusting, especially over bony prominences. The disease is often found in association with immunosuppression, down's syndrome, mental retardation and in patients with diminished sensation. Recently a significant association with human T-lymphotropic virus type I (HTLV-I) and adult T-cell leukaemia/lymphoma (ATL) has been reported. Over a 30-month period, 18 patients with crusted scabies were admitted to the dermatology ward, University Hospital of the West Indies, Mona. Of these patients, 13 (72 percent) were found to be HTLV-I seropositive and 4 of this group on further investigation were found to have ATL. The remainder of patients had other HTLV-I associated disease (tropical spastic paraparesis, infective dermattis with lymphocytic interstitial pneumonitis and psoriasiform eczema), immunosuppression due to a carcinoma and malnutrition associated with a cerebrovascular accident, lupus erythematosus on corticosteroid, and in 4 patients no underlying cause was found. Because of this strong association of crusted scabies with HTLV-I seropositivity and HTLV-I associated diseases in our environment, the determination of HTLV-I serostatus and investigation for possible ATL are mandatory in patients with this unusual form of scabies. (AU)