Crusted scabies (Norwegian scabies) is uncommon in clinical practice and may present as papulosquamous dermatosis. A case of crusted scabies in systemic lupus erythematosus (SLE) is described. The skin lesions simulated those of subacute cutaneous lupus erythematosus of the papulosquamous type, and became the source of epidemic scabies in the hospital. The colonization with Staphylococcus aureus within crusted lesions may have contributed to the patient's sepsis. This case illustrates the pitfalls in recognition of crusted scabies and the importance of rapid diagnosis.