A 48-year-old man who received a liver transplant and is taking immunosuppressive medications developed a scaly rash on his back and shoulders. He is receiving hospice care at a nursing home. He was initially seen in urgent care and treated with antifungal cream and topical corticosteroids. After treatment, the rash did not improve. A skin smear shows numerous scabies mites and eggs. A diagnosis of crusted scabies is made.