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Background: Scabies is a highly contagious, neglected cutaneous parasitic disease, associated with poor individual, community, environmental circumstances and health. Hospital acquired scabies may occur due to contact between patients and healthcare providers. The non-classic presentation of scabies presents a challenging case to the clinician.
Case presentation: A male healthcare provider presented with a dry, itchy rash on his lower legs which was non-responsive to initial chemotherapy, developing complicated hypersensitivity symptoms. Later skin biopsy and scrapings yielded Sarcoptes mites.
Management: During the first 2 weeks, the patient was dewormed at a health centre and later given intramuscular, oral and topical antihistamines a referral hospital with little improvement. A final dose of ivermectin cleared the rash and itching.
Conclusion: WE present a case of nosocomial atypical scabies in a healthcare worker which posed a rare challenge. A complicated clinical history and previous medications appear to have masked the classic features.