{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,28]],"date-time":"2026-03-28T22:17:06Z","timestamp":1774736226256,"version":"3.50.1"},"reference-count":5,"publisher":"BMJ","issue":"12","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2025,12,12]]},"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:p>We report a patient with biopsy-proven Hailey-Hailey disease (HHD) in remission who presented with itchy, painful flexural lesions. Initial findings suggested relapse of HHD, but within 72 hours, he developed joint pain, fever, incoherent speech, hallucinations and thick crusted plaques. Skin scrapings confirmed crusted scabies, and he showed irrefutable clinical improvement with oral ivermectin. Our case illustrates the interplay between generalised HHD and crusted scabies, and its rare systemic complications involving the musculoskeletal and neuropsychiatric systems.<\/jats:p>","DOI":"10.1136\/bcr-2025-269918","type":"journal-article","created":{"date-parts":[[2025,12,30]],"date-time":"2025-12-30T18:05:21Z","timestamp":1767117921000},"page":"e269918","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Unmasking crusted scabies in Hailey-Hailey disease: a systemic syndrome with musculoskeletal and neuropsychiatric manifestations"],"prefix":"10.1136","volume":"18","author":[{"given":"Sudhesshna","family":"Devi","sequence":"first","affiliation":[{"name":"Dermatology, Venereology and Leprosy, Saveetha Institute of Medical and Technical Sciences (Deemed to be University), Chennai, Tamil Nadu, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-2883-4082","authenticated-orcid":false,"given":"Ragadharshini","family":"E","sequence":"additional","affiliation":[{"name":"Dermatology, Venereology and Leprosy, Saveetha Institute of Medical and Technical Sciences (Deemed to be University), Chennai, Tamil Nadu, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,12,30]]},"reference":[{"key":"2025123016251306000_18.12.e269918.1","doi-asserted-by":"crossref","first-page":"479","DOI":"10.3390\/idr14030051","article-title":"Crusted Scabies, a Neglected Tropical Disease: Case Series and Literature Review","volume":"14","author":"Niode","year":"2022","journal-title":"Infect Dis Rep"},{"key":"2025123016251306000_18.12.e269918.2","doi-asserted-by":"crossref","first-page":"585","DOI":"10.1111\/pim.12133","article-title":"Parasitic scabies mites and associated bacteria joining forces against host complement defence","volume":"36","author":"Swe","year":"2014","journal-title":"Parasite Immunol"},{"key":"2025123016251306000_18.12.e269918.3","doi-asserted-by":"publisher","DOI":"10.1007\/s00436-024-08173-6"},{"key":"2025123016251306000_18.12.e269918.4","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1046\/j.1365-2133.2001.03992.x","article-title":"Hailey-Hailey disease: exacerbation by scabies","volume":"144","author":"Gerdsen","year":"2001","journal-title":"Br J Dermatol"},{"key":"2025123016251306000_18.12.e269918.5","doi-asserted-by":"crossref","first-page":"e178","DOI":"10.1111\/1346-8138.15783","article-title":"A novel deletion mutation in the ATP2C1 gene in a case of generalized Hailey-Hailey disease possibly aggravated by scabies infection","volume":"48","author":"Ikeda","year":"2021","journal-title":"J Dermatol"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2025-269918","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T00:25:21Z","timestamp":1767140721000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2025-269918"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12]]},"references-count":5,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2025,12,30]]},"published-print":{"date-parts":[[2025,12]]}},"alternative-id":["10.1136\/bcr-2025-269918"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2025-269918","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12]]}}}