{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T13:20:59Z","timestamp":1783948859316,"version":"3.55.0"},"reference-count":48,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2025,3,10]],"date-time":"2025-03-10T00:00:00Z","timestamp":1741564800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"\u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background and Clinical Significance: The current paper presents a retrospective case of a 79-year-old female patient admitted to the Dermatology Clinic of Emergency City Hospital in Timisoara, Romania, in January 2022, reporting intense pruritus and burning sensation of the skin exacerbated at night. Case Presentation: The previously mentioned symptoms appeared approximately six months prior, with gradual and continuous progression. Clinical examination revealed widespread hyperkeratosis on diffuse erythematous background across the entire body, accompanied by crusted lesions predominantly on the arms and legs. Laboratory values showed elevated absolute eosinophil count as well as a positive culture swab to Staphylococcus aureus. Two incisional skin biopsies were performed. Microscopic examination in Hematoxylin\u2013Eosin staining revealed thickened stratum corneum with numerous oval-shaped mites with exoskeleton and striations and moderate perivascular lympho-eosinophilic infiltrate in the superficial dermis, leading to a positive diagnosis of crusted scabies. Following etiological treatment, the patient\u2019s evolution was undulating and on the 10th day of hospitalization presented marked dyspnea, followed by cardiorespiratory arrest, leading to the patient\u2019s death. Conclusions: The patient\u2019s outcome could be explained by a Th2-mediated allergic response to Sarcoptes scabiei allergens, in addition to the presence of Staphylococcus aureus on the damaged skin, as dysbiosis can further support an uncontrolled Th2 reaction, leading to anaphylaxis.<\/jats:p>","DOI":"10.3390\/diagnostics15060680","type":"journal-article","created":{"date-parts":[[2025,3,10]],"date-time":"2025-03-10T12:02:59Z","timestamp":1741608179000},"page":"680","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Tiny Troublemakers\u2014A Comprehensive Approach to Crusted Scabies"],"prefix":"10.3390","volume":"15","author":[{"given":"Antonia","family":"Armega-Anghelescu","sequence":"first","affiliation":[{"name":"Department of Pathology, Emergency City Hospital, 300254 Timisoara, Romania"},{"name":"Department of Microscopic Morphology, \u201cVictor Babes\u201d University of Medicine and Pharmacy, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-1397-1864","authenticated-orcid":false,"given":"Raluca-Maria","family":"Closca","sequence":"additional","affiliation":[{"name":"Department of Pathology, Emergency City Hospital, 300254 Timisoara, Romania"},{"name":"Department of Microscopic Morphology, \u201cVictor Babes\u201d University of Medicine and Pharmacy, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daliborca-Cristina","family":"Vlad","sequence":"additional","affiliation":[{"name":"Department of Pharmacology and Biochemistry-Pharmacology, \u201cVictor Babes\u201d University of Medicine and Pharmacy, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florentina-Camelia","family":"Cioenaru","sequence":"additional","affiliation":[{"name":"Department of Pathology, Emergency City Hospital, 300254 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marina","family":"Rakitovan","sequence":"additional","affiliation":[{"name":"Department of Microscopic Morphology, \u201cVictor Babes\u201d University of Medicine and Pharmacy, 300041 Timisoara, Romania"},{"name":"Oro-Maxillo-Facial Surgery Clinic, Emergency City Hospital, 300062 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia","family":"Cristodor","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Emergency City Hospital, 300254 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3784-902X","authenticated-orcid":false,"given":"Caius-Silviu","family":"Solovan","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Emergency City Hospital, 300254 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4320-229X","authenticated-orcid":false,"given":"Marco-Cristian","family":"Marian","sequence":"additional","affiliation":[{"name":"Department X, 2nd Surgical Clinic, Researching Future Chirurgie 2, \u201cVictor Babes\u201d University of Medicine and Pharmacy, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria-Bianca","family":"Ilas-Tat","sequence":"additional","affiliation":[{"name":"Department of Pathology, Emergency City Hospital, 300254 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Flavia","family":"Zar\u0103","sequence":"additional","affiliation":[{"name":"Department of Pathology, Emergency City Hospital, 300254 Timisoara, Romania"},{"name":"Department of Microscopic Morphology, \u201cVictor Babes\u201d University of Medicine and Pharmacy, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,3,10]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"533","DOI":"10.1016\/j.jaad.2019.05.109","article-title":"Ectoparasites: Scabies","volume":"82","author":"Thomas","year":"2020","journal-title":"J. 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