On hematoxylin-eosin staining, numerous exoskeletons of Sarcoptes scabiei were identified in the stratum corneum. These findings are consistent with crusted scabies infection.
On repeated questioning of the patient, it was discovered that she had been admitted to another institution several months before our evaluation and had undergone treatment for her disease with a 10-day course of daily topical permethrin cream. She denied any improvement in response to this treatment in either the size or the number of plaques and thus sought further evaluation and care of her condition.
Hyperkeratotic Plantar Plaques in an HIV-Positive Patient. Arch Dermatol. 1998;134(8):1019-1024. doi: