IGHE and skin reaction: Research indicates that IgE levels and peripheral eosinophil counts in patients with Norwegian scabies correlate with the severity of skin reactions.[12,13] Interestingly, the patient’s peripheral blood eosinophil count was not elevated, which may be attributed to CD4+ T cell exhaustion resulting from HIV infection, thereby weakening the Th2 immune response.[1,14] Additionally, bone marrow suppression could impair the differentiation of hematopoietic progenitor cells, leading to reduced eosinophil production.