Diagnosis: Infantile scabies
Case submitted by Shahbaz A. Janjua to the dermRounds community.
Clinical photograph(s) submitted for peer review and discussion.
Submitted by Shahbaz A. Janjua. Originally posted March 10, 2010.
See case discussion.
• Atopic dermatitis • Contact dermatitis • Insect bites • Dermatitis herpetiformis • Prurigo nodularis • Bullous pemphigoid • Drug eruption
• Caused by Sarcoptes scabiei var. hominis — obligate human parasite • Pruritus is an allergic reaction to mite proteins — may take 2-6 weeks to develop in first infection • Pathognomonic finding: burrow (S-shaped or linear tunnel) in web spaces, wrists, elbows • Crusted (Norwegian) scabies: massive mite burden in immunocompromised — highly contagious • Treat all household contacts simultaneously even if asymptomatic • Post-treatment pruritus may persist for 2-4 weeks — does not indicate treatment failure • Dermoscopy: "delta wing" or "hang glider" sign (triangular, brown structure = mite head) • Nodular scabies: persistent pruritic nodules (hypersensitivity reaction) may persist for months after treatment
Tags: infantile, scabies, shahbaz a. janjua