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[P296] Bullous scabies: a case report and review of the literature
( Jong Sic Kim ),( Yu Ri Woo ),( Miri Kim ),( Hyun Jeong Park ) 대한피부과학회 2017 대한피부과학회 학술발표대회집 Vol.69 No.1
Scabies is a common parasitic infection caused by the miteSarcoptes Scabiei. It is characterized by an erythematous excoriated papulovesicular rash, burrows, nodules and hyperkeratotic lesions in specific body areas. However, bullous scabies is a rare subtype that can mimic clinically and histologically bullous pemphigoid. Herein, we report a rare case of bullous scabies. A 78-year-old patient with diabetes mellitus presented with a 3-day of intensely pruritic, multiple, tense, 1-3 cm sized bullae on trunk and both extremities including both palms. He had been treated for chronic urticaria for several years with antihistamines. The symptoms have been recently aggravated with newly developed bullae and poor response to antihistamines and steroid. The skin biopsy revealed a subepidermal blister, superficial perivascular infiltrate with abundant eosinophils. Although histopathologic findings failed to show a scabies mite, and mite scraping was negative, the patient was clinically diagnosed with bullous scabies and treated with gamma benzene hexachloride cream. After 1 week, the bullae started to disappear with significant improvement of pruritus. The pathogenesis of bullae formation in scabies is not entirely understood. Several mechanisms have been suggested such as Staphylococcus Aureus superinfection and autoantibody. The diagnosis of scabies should be considered in the patients who present with tense bullae with severe pruritus, especially when the skin lesions do not resolve with conventional therapy.
Scabies presenting as atypical vesicular manifestations
( Young Wook Ko ),( Tae Lim Kim ),( Won Seon Koh ),( Jeong Eun Kim ),( Joo Yeon Ko ),( Young Suck Ro ) 대한피부과학회 2018 대한피부과학회 학술발표대회집 Vol.70 No.1
Scabies is a contagious infestation caused by the mite, Sarcoptes scabiei. The common presentations of scabies are linear burrows, pruritic papules, and inflammatory nodules. Vesicular and bullous lesions are rare in scabies. Because of its clinical and histopathologic non-specific nature, vesicular scabies may be difficult to diagnose early. We report two cases of scabies presented with vesicular lesions. A 35-year-old male with quadriplegia due to subarachnoid hemorrhage presented with multiple erythematous vesicles and pustules that appeared on his hands 2 weeks ago. Biopsy specimen from the right palm showed subcorneal blister and eosinophilic infiltration in the dermis. He treated with topical steroids for 3 months, but new inflammatory nodules and pruritic papules developed on his whole body, especially on flexural areas. Then, the KOH test was performed and scabies mites were found. Second case was a 13-year-old boy with itchy multiple vesicles on whole body which have lasted 2 months. Histopathologic examination from a vesicle of the left lower leg revealed subepidermal cleft and DIF showed negative finding. A KOH test was performed and several mites were found. After topical permethrin and oral antihistamine treatments for both patients, their skin lesions showed marked improvement. Therefore, scabies should be considered as a differential diagnosis if itchy vesicular skin lesion of unexplained etiology occurs.
Bullous scabies mimicking bullous pemphigoid
( Tae Han Kim ),( Gwang Hoon Kim ),( Do Hun Kim ),( Nam Hee Sung ),( Hyo Seung Shin ),( Ai Young Lee ),( Seung Ho Lee ) 대한피부과학회 2015 대한피부과학회 학술발표대회집 Vol.67 No.1
Scabies is an infection caused by Sarcopets scabiei. The characteristic presentations of the disease are classic burrows, papules, nodules, excoriation and crusts. Bullous lesions are an atypical manifestation of scabies that is most commonly seen in the elderly. We report a case of bullous scabies that mimicked bullous pemphigoid in clinical and histopathological examination. A 69-year-old man presented with a 5-month history of multiple tense bullae on the extremities. Closed physical examination revealed erosive erythematous patches with a few burrows on the both axillae. Direct smear of the burrow on the axillar was positive for Sarcopets scabiei. the mites were also seen in the bullous lesion on the palm. Biopsy specimen from a recent bulla revealed subepidermal blister with massive eosinophils and lymphocytes infiltration in the superficial dermis. Direct immunofluorescence was negative. Skin lesions improved after treatment with applications of lindane 1% lotion and a short course of oral corticosteroids.
강진희 ( Jin Hee Kang ),이지현 ( Ji Hyun Lee ),김태윤 ( Tae Yoon Kim ) 대한피부과학회 2014 대한피부과학회지 Vol.52 No.8
We report a rare case of bullous scabies with bullous pemphigoid in a 59-year-old male patient. He presented with a 9-month history of exhibiting multiple, variable-sized, red-to-brown, pruritic cutaneous patches, and papules with tense bullae on his whole body. A direct smear of the bullous lesions was performed and was negative for scabies mites. Histopathologic findings (hematoxylin and eosin staining) revealed Sarcoptes scabiei in the stratum corneum. There were sub-epidermal blisters with massive eosinophil and lymphocyte infiltration in the epidermis and upper dermis. Direct immunofluorescence microscopy showed linear deposition of IgG at the dermo-epidermal junction. Indirect immunofluorescence microscopy of samples acquired for the salt-split skin test showed linear IgG deposition in the epidermis. Skin lesions improved after the patient was treated with an anti-scabietic and steroids. (Korean J Dermatol 2014;52(8):563∼566)
하지현 ( Ji Hyun Ha ),최문정 ( Moon Jung Choi ),김태윤 ( Tae Yoon Kim ),김수찬 ( Soo Chan Kim ),이준영 ( Jun Young Lee ) 대한피부과학회 2003 대한피부과학회지 Vol.41 No.3
We report a case of bullous scabies in an 81-year-old male patient. He had severe pruritic, multiple tense bullae on erythematous base with erosions and crusts from which scabies mites were identified. Histopathologic findings(H&E) revealed subepidermal b