Abstract
BackgroundScabies is a common parasitic infection caused by the mite Sarcoptes Scabiei. About 300 million cases of scabies are reported annually. Scabies usually presents clinically with an erythematous excoriated papulovesicular rash, burrows, nodules and hyperkeratotic lesions in specific body areas.A rare presentation of scabies is the bullous pemphigoid-like bullous scabies. So far, to the best of our knowledge, only 32 cases of bullous scabies have been reported in medical literature, of which only 11 were under 60 years of age at the time of initial presentation. This is the first case of bullous scabies being reported from Pakistan.Case presentationHerein we discuss, with reference to the existing literature, the case of a 23-year-old Punjabi male who presented with a 3 day history of a tense, non-erythematous, non-tender bulla measuring approximately 0.5 cm x 0.8 cm on the right foot near the interdigital cleft. He was diagnosed to have bullous scabies.ConclusionThe diagnosis of scabies should be considered in all patients who present with tense bullous lesions accompanied by pruritus and a maculopapular rash. This is particularly relevant if these lesions do not resolve with steroid treatment. In such patients, in order to prevent a misdiagnosis of bullous pemphigoid, scrapings for Sarcoptes Scabiei mites and eggs should be taken.
Highlights
Scabies is a common parasitic infection caused by the mite Sarcoptes Scabiei
The diagnosis of scabies should be considered in all patients who present with tense bullous lesions accompanied by pruritus and a maculopapular rash
In order to prevent a misdiagnosis of bullous pemphigoid, scrapings for Sarcoptes Scabiei mites and eggs should be taken
Summary
It is suggested that the diagnosis of scabies be considered in all patients who present with tense bullous lesions accompanied by pruritis and a papular rash. This is relevant if these lesions do not resolve with steroid treatment. Suspecting scabies in such patients is of paramount importance, as it may co-exist with bullous pemphigoid, but is an important possible precipitant for this condition. Authors’ contributions All the authors contributed to the intellectual content of this article, including the concept, literature search, interpretation of current available data on the subject and derivation of a meaningful conclusion.
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