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 a...
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.