Abstract
A 39-year-old woman reported to her general practitio-ner with a new pigmented skin lesion on her right pectoral region. Dermatoscopically there were no suspicious features and the decision was made to monitor it over a three-month period. At follow-up imaging there was some minor change, possibly related to technical factors (the original camera/dermatoscope combination was not available), and after dis-cussion with the patient a decision was made to perform an excisional biopsy. The pathologist reported the lesion as a: “… dysplastic naevus of the compound type” with “… mild atypia and active lymphocytic regression.” He made the addi-tional comment: “Two apparent scabies mites are present.” This was not expected, as the patient had complained of no symptoms of scabies and no skin eruption had been observed to suggest that diagnosis.The patient returned for her routine postoperative review one week after the excision. She now complained of an intensely itchy skin eruption and wondered if she was having an allergic reaction to the local anaesthetic or antiseptic skin preparation solution used at the time of surgery. Examination
Highlights
Case presentationA 39-year-old woman reported to her general practitioner with a new pigmented skin lesion on her right pectoral region
The patient returned for her routine postoperative review one week after the excision
Scabies infestation is caused by Sarcoptes scabiei var hominis, an obligatory human parasite, which spreads from person to person by transmission of fertilised female mites by direct skin contact [1]
Summary
A 39-year-old woman reported to her general practitioner with a new pigmented skin lesion on her right pectoral region. He made the additional comment: “Two apparent scabies mites are present.”. This was not expected, as the patient had complained of no symptoms of scabies and no skin eruption had been observed to suggest that diagnosis. The patient returned for her routine postoperative review one week after the excision. She complained of an intensely itchy skin eruption and wondered if she was having an allergic reaction to the local anaesthetic or antiseptic skin preparation solution used at the time of surgery. Appropriate topical treatment was prescribed and the symptoms and signs of scabies resolved over a period of weeks. The source of infestation was not identified and no household member or other personal contact was reported to have developed symptoms prior, or subsequent to, this case
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