People with a weakened immune system may develop the severe form of scabies called crusted scabies. We have two cases of female patients with history of using long-term oral corticosteroid and then developing scabies infection. The first patient had other comorbidities which caused her become more susceptible while the second patient had been diagnosed with bullous pemphigoid. Both patients complained thick crust on some parts of their bodies, accompanied with itchy papules. Based on microscopic examination from lesion scraping, we found the adult form of sarcoptes scabiei and crusted scabies diagnosis was established. The lesions were improving when they got combination of topical sulfur precipitate, salicylic acid, and permethrine 5%. Crusted scabies is characterized by hyperkeratosis and crusting of the skin due to the profuse proliferation of mites resulting from an altered host response. Combination of topical antiscabies and keratolytic can make the crusts thinner and improve topical absorption.

Crusted scabies is characterized by hyperkeratosis and crusting of the skin due to the profuse proliferation of mites. It is resulting from an altered host response to the infestation. There are some various cutaneous and immunologic diseases that have been described to predispose to crusted scabies. It is typically associated with congenital and acquired immunocompromised conditions including human immunodeficiency virus (HIV), hematologic malignancy, and connective tissue diseases, including systemic lupus erythematosus (SLE). Adults with crusted scabies may lack the characteristic rash or itching. Sites of presentation have been reported on the scalp, face, neck, extremities, trunk, hands, and feet. The severe condition of SLE and super infection of scabies in the immunocompromised state highlight the need for appropriate care to avoid further morbidity. This case report aims to describe the characteristic of skin lesions and clinical aspects of crusted scabies in SLE. A 28-year-old man was diagnosed with crusted scabies who was treated more intensely with permethrin 5% cream that was combined with 2-4 ointment. There was clinical improvement and no side effect found during this study.

Background: Oral candidiasis is an infection due to the activity of Candida albicans in the oral cavity. Oral candidiasis is one of the most common opportunistic infections occuring among Human Immunodeficiency Virus (HIV)/Acquired immune deficiency syndrome (AIDS) patients. Due to increasing resistance and adverse effects to commonly used antifun¬gal drugs, many recent studies have examined the use of herbal essential oils as antifungal agents. In this study, essential oil of Rosmarinus officinalis (Lamiaceae) and nystatin were examined for in vitro antifungal activ¬ity against Candida species. Aim: To evaluate antifungal activity of essential oil of Rosmarinus officinalis (Lamiaceae) and nystatin by comparing inhibition zone diameters. Methods: This study was an experimental laboratory study with a posttest only design conducted in Dr. Soetomo General Academic Hospital, Surabaya. Forty isolates consisted of 20 isolates of Candida albicans and Candida non-albicans were subjected to test for antifungal activity using the diffusion disk method using paper discs or blank discs and inhibitory zones were recorded. Results: Diffusion test results revealed stronger antifungal effect of nystatin against all analyzed Candida strains. This study showed the mean diameter of the inhibitory zone for Candida albicans formed by rosemary essential oil is 2.25 mm and the average inhibition zone formed by rosemary essential oil for Candida non-albicans is 1.5 mm. Conclusion: The antifungal activity of nystatin is stronger when compared to rosemary essential oil as seen from a greater inhibition zone than rosemary essential oil in the diffusion method.

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