Crusted scabies is a rare form of classic scabies characterized by severe symptoms, mainly observed in immunosuppressed patients. This disease has been associated with a variety of health problems, such as delayed diagnosis, infection risk, and high mortality, mainly from sepsis. We report the case of a patient with hyperkeratotic scabies in the context of immunosuppression associated with malnutrition and the use of topical corticosteroids. Ivermectin is critical for successfully treating crusted scabies. However, a higher cure rate has been reported with the combination of oral ivermectin and topical permethrin. In our study, we chose to use a plan suitable for grade two scabies, resulting in a subtotal regression of the lesions. Crusted scabies is a highly contagious parasitic cutaneous disease, and there are few reports in the national and international literature. It is necessary to suspect this presentation form in order to establish a timely diagnosis and detect and treat associated comorbidities.

Seventy years ago, Robin Mole introduced the concept of the abscopal effect to describe a rare phenomenon. This occurs when local radiation triggers an immune-mediated reduction in tumors outside the treated area but within the same organism. Observing this effect has been linked to improved overall and progression-free survival in patients who experience it. While the abscopal effect was once considered rare, it is now being observed more frequently due to the combination of radiation with immunotherapy. As a result, more researchers are exploring this study area, which shows promise for excellent results. This review focuses explicitly on the immunological implications of activating the abscopal effect through ionizing radiation in the central nervous system and explores the potentially involved immunological pathways.

Sellar and parasellar tumors occupy a compact neurovascular region where millimetric differences in extension determine whether an effective dose is deliverable while preserving vision, endocrine function, and hypothalamic and cranial-nerve function. Evidence for choosing among single-fraction stereotactic radiosurgery (SRS), hypofractionated stereotactic radiotherapy in three to five fractions (hfSRT), and conventionally fractionated precision radiotherapy (cfRT) is fragmented, largely retrospective, and heterogeneous in visual and toxicity reporting. This structured narrative review integrates evidence for pituitary neuroendocrine tumors, craniopharyngiomas, and sellar or parasellar meningiomas, prioritizing guidelines, systematic reviews, multicenter cohorts, and studies with quantitative visual outcomes. Indication depends on histology and behavior; modality selection depends on target volume, optic contact, canal involvement, pathway deformation or encasement, temporal stability, previous treatment, and achievable coverage. Single-fraction SRS suits compact, stable targets coverable within organ-at-risk limits; hfSRT can improve deliverability for focal peri-optic interfaces; and broad contact, large or irregular targets, dynamic cystic anatomy, pediatric disease, and complex multi-organ geometry favor cfRT. Automated perimetry and optical coherence tomography (OCT) provide complementary functional and structural measures; isolated OCT change cannot alone diagnose radiation-induced optic neuropathy. We propose an anatomy-based framework weighing target coverage and functional risk together; it synthesizes observational evidence and is not prospectively validated.

In peri-optic sellar and parasellar tumors, visual preservation requires protection from both radiation injury and progression of inadequately controlled disease. This structured narrative review synthesizes guidelines, systematic reviews, and clinical cohorts identified through targeted PubMed/MEDLINE searches updated through 22 August 2026, covering pituitary neuroendocrine tumors, craniopharyngiomas, and meningiomas. Predominantly retrospective evidence and inconsistent functional reporting limit comparisons between radiation modalities. We propose an anatomy-based framework integrating therapeutic intent, tumor–optic geometry, achievable target coverage, anatomical stability, prior treatment, and baseline visual and endocrine function. Minimum tumor–optic distance alone is insufficient for modality selection. Single-fraction stereotactic radiosurgery is suited to compact, stable targets when disease-specific coverage is achievable within organ-at-risk limits. Hypofractionated stereotactic radiotherapy in three to five fractions may address focal peri-optic dose conflicts, whereas conventionally fractionated precision radiotherapy may accommodate broad contact, complex geometry, or dynamic cystic disease. Automated perimetry, optical coherence tomography, and axis-specific endocrine assessment support longitudinal surveillance; isolated retinal thinning does not establish radiation-induced optic neuropathy. New functional deficits require assessment of tumor status, treatment chronology, spatial dose, and competing causes. The proposed framework requires prospective validation and provides a practical basis for multidisciplinary decisions that jointly evaluate durable tumor control and long-term functional preservation.