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2017 ; 10
(ä): 317-324
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Scabies masquerading as bullous pemphigoid: scabies surrepticius
#MMPMID28883737
Cohen PR
Clin Cosmet Investig Dermatol
2017[]; 10
(ä): 317-324
PMID28883737
show ga
Scabies, a parasitic infestation caused by the mite Sarcoptes scabiei, is
diagnosed by observing either the mite, its ova, or its excrement. The mite
tracts, known as burrows and a characteristic presentation of the pruritic
condition, are typically found on the web spaces between the fingers. Other
cutaneous lesions include excoriated papules, pustules, and vesicles. However,
atypical clinical variants of scabies, such as bullous, crusted, hidden,
incognito, nodular, and scalp forms of the parasitic infestation, mimic the
morphologic features of other non-parasitic dermatoses. A 76-year-old man
presented with pruritic blisters and urticarial plaques that demonstrated not
only pathology changes, but direct immunofluorescence also showed findings of
bullous pemphigoid. His condition improved, but did not resolve, with topical
corticosteroid cream for the management of the primary autoimmune blistering
disorder. When other family members subsequently developed scabies, the correct
diagnosis for his condition, bullous scabies, was established by demonstrating
mites, ova, and scybala on a mineral oil preparation from a skin scraping of a
newly appearing burrow. Bullous scabies can masquerade not only clinically, but
also both pathologically and immunologically as bullous pemphigoid. Scabies
serrupticius is introduced as a unifying term to designate all of the non-classic
presentations of S. scabiei mite infestation.