Bullous Scabies Research Articles

Concomitant Bullous and Crusted Scabies A Rare Presentation

Scabies is a highly contagious skin condition caused by an infestation of the mite Sarcoptes scabiei. The mites burrow into the upper layers of the skin and lay their eggs, causing intense itching and characteristic linear burrows. There are several atypical clinical variants of scabies, including bullous, crusted, hidden, incognito, nodular, and scalp scabies. Bullous scabies is an uncommon variant, characterized by the formation of large, fluid-filled blisters (bullae) on the skin. Crusted scabies, also known as Norwegian scabies, is a severe and highly contagious form of scabies characterized by thick, crusted lesions on the skin. In this case report, we present a rare case of a 69-year-old man with concomitant bullous and crusted scabies. The patient was treated with a whole-body application of benzyl benzoate lotion and two doses (12mg) of oral ivermectin, two weeks apart, and the skin lesions disappeared 20 days later. This case highlights the importance of considering scabies as a differential diagnosis in patients presenting with bullous lesions and the need for careful examination and investigation to distinguish between bullous scabies and bullous pemphigoid.

Bullous scabies, the light shed on etiopathogenesis and treatment: report of five paediatric cases.

Bullous scabies (BS) is an infrequent and atypical presentation of scabies, with a predilection for elderly males. The mechanism of BS is not fully understood; superinfection, friction due to pruritus, autoeczemation, direct injury from mite's lytic enzymes, cross-reactivity of scabies protein with basal membrane zone antigens are considered to be possible reasons. To define clinical features of paediatric BS cases, which is an extremely rare subtype of scabies. This is a retrospective study of paediatric BS cases seen at two tertiary care centres. Previously described bacterial culture, antibiogram and follow-up records were investigated retrospectively. Confirmed scabies cases, according to the "International Alliance for the Control of Scabies (IACS)" with bullae were included. All cases were treated with 10% sulfur ointment for 3 consecutive days, two cycles. Households of cases were also treated simultaneously. Systemic antibiotics were added to patients with elevated acute phase reactants according to the antibiogram results. Informed consent was obtained from patients' parents. Five BS cases were included. Three cases were male, two cases were female. Four cases had staphylococcus aureus, one had group-A beta haemolytic streptococcus positive bullae culture. All cases achieved a rapid complete resolution of symptoms after topical 10% sulfur ointment. Paediatric BS is an extremely rare entity of scabies. Bacterial superinfection plays a key role in bullae formation. 10% sulfur ointment is a highly effective treatment option for paediatric BS.

A case series on bullous pemphigoid like scabies: A diagnostic challenge

Scabies is an ectoparasitic infection caused by Sarcoptes scabiei var. hominis in humans. Accurate figures of the prevalence of scabies are difficult to obtain, it seems to affect around 100–300 million people worldwide. Scabies is usually transmitted by close intimate physical contacts, such as the sharing of a bed or prolonged hand-holding. Scabies mites survive for 24–36 h outside of human bodies. Itching is the most obvious manifestation of scabies, which is usually sparing the face in adult classic scabies. The onset occurs 3–4 weeks after acquiring the infection. Bullous pemphigoid-like scabies is one of the atypical and rare forms of scabies that may be overlooked and mismanaged, where only 44 cases worldwide with this mode of presentation were reported. Here, we reported a series of three cases of bullous pemphigoid-like scabies, which presented with nocturnal itching and vesiculobullous lesions that are to the best of our knowledge the first cases reported in our country

Bullous Pemphigoid and Scabies: Is There an Association?

Bullous Pemphigoid (BP) is an autoimmune subepithelial bullous disease. Several reports suggested an association between BP and scabies. We aimed to evaluate whether an association between BP and scabies exists. This is a retrospective matched case-control study. We retrospectively identified BP patients treated in our clinic between January 1, 2009, and December 31, 2016. Each patient was assigned to 3 control subjects (matched by age and sex) treated in our clinic, not due to BP. The study group was examined for a scabies diagnosis within the 3 years prior to BP diagnosis; the control group was examined for a scabies diagnosis 3 years prior to its first visit in our clinic. Fifteen out of the 87 (17.2%) BP patients were diagnosed with scabies within the 3 years prior to their initial BP diagnosis, compared to only 4.2% (11 out of 261) among the control group. The odds ratio of scabies history was 4 times higher among BP patients compared to the control group (OR=4.23; 95% CI: 1.50–11.91, P=0.007). A retrospective study design. An association between scabies diagnosis and BP is demonstrated in our study. J Drugs Dermatol. 2022;21(9):1009-1011. doi:10.36849/JDD.4900.

Bullous Scabies: Clinical, Dermoscopic, and Pathologic Characteristics of Ten Patients

Bullous scabies (BS) is a rare atypical clinical variant of scabies and is easily confused with bullous disorders. The diagnosis of BS is always a challenge, and physicians often misdiagnose BS patients. Patients with BS admitted from 2012 to 2020 were enrolled in this study. The clinical, dermoscopic, and pathological characteristics of the patients were analyzed retrospectively. Ten patients with BS were enrolled in this study. Seven of the 10 patients were male. The bullae were most commonly found on the thighs and arms (80% of patients). Only 30% of patients (3/10) tested positive for mites and/or eggs by the initial skin scraping, but 100% (5/5) of the patients who received dermoscopy tested positive. Among these 10 patients, only five received a skin biopsy. Subepidermal (4/5) and intraepidermal (1/5) bullae with eosinophil and neutrophil infiltration were observed in five patients. Direct immunofluorescence (DIF) indicated linear deposition of IgG in the basement membrane zone in three patients. Physicians should consider the possibility of BS in patients with blisters, pruritus, and poor response to corticosteroids. Dermoscopy should be prioritized for the differential diagnosis of BS to exclude other bullous disorders. Finally, a biopsy should be performed on each patient with bullae.

Scabies: A Neglected Global Disease.

Scabies is a skin disease caused by an obligate human parasite mite Sarcoptes scabiei var. hominis. Children under the age of two and elderly individuals are at the greatest risk. Knowledge of this condition is important for an early diagnosis to be made and treatment to be initiated. The review aimed to familiarize physicians with the clinical manifestations, diagnosis, evaluation, and management of scabies. A search was conducted using Pubmed with the built-in "Clinical Queries" tool. The search term "Scabies" was used. The categories of "epidemiology", "diagnosis", "therapy", "prevention" and "prognosis" had a limited scope for primary clinical studies. Meta-analyses, randomized controlled trials, clinical trials, observational studies, and reviews were included. Only papers published in the English language were included. A descriptive, narrative synthesis was provided of the retrieved articles. Worldwide, scabies affects 200 to 300 million individuals annually. The average prevalence is estimated to be 5 to 10% in children of developing countries. Transmission usually occurs after close prolonged skin-to-skin contact. Classic scabies is characterized by an erythematous papular eruption, serpiginous burrows, and intense pruritus. Sites of predilection include the webs of the fingers, volar wrists, lateral aspects of fingers, extensor surfaces of elbows and knees, waist, navel, abdomen, buttocks, groins, and, genitals. A clinical diagnosis of classic scabies can be made on the basis of the history and clinical findings. Other clinical variants include crusted scabies, nodular scabies, and bullous scabies. Finding the mite, ova, or fecal pellets on microscopic examination of scrapings taken from skin lesions confirms the diagnosis of scabies infestation. For eradication of scabies mites, the drugs of choice are topical permethrin and oral ivermectin. Scabies is a highly contagious parasitic cutaneous disease that is stigmatising and debilitating. Increased awareness, accurate diagnosis, and prompt treatment are essential for the effective control of scabies and for the prevention of the spread of the disease.

Scabies surrepticius captured by dermoscope

Scabies is a common skin infection, but bullous scabies is not only rare but also easy to be misdiagnosed by clinicians. Dermoscope can rapid and accurately diagnose scabies, as well as bullous scabies. We report a case of bullous scabies diagnosed by dermoscopy.

Bullous Pemphigoid: Use of C4d Immunofluorescent Staining in a Case With Repeated Negative Conventional Direct Immunofluorescence Studies

Direct immunofluorescence (DIF) using frozen section material from a fresh/preserved perilesional biopsy is the gold standard for the immunopathologic diagnosis of bullous pemphigoid (BP). DIF in BP shows linear dermoepidermal junction (DEJ) staining for C3, with or without staining for IgG. In some situations, only a formalin-fixed lesional biopsy is obtained (with no fresh/preserved perilesional biopsy for DIF). In this setting, paraffin section C4d immunohistochemistry has proven to be diagnostically useful, demonstrating linear DEJ positivity for C4d. We present a novel use of C4d staining for the diagnosis of BP, specifically analyzing C4d perilesional frozen section DIF in a case where standard perilesional frozen section DIF for IgG/C3 was available, but was negative. An 80-year-old woman presented with a pruritic bullous lesion on her left upper extremity, clinically thought to represent BP. Lesional histologic findings were typical for BP, but perilesional frozen section DIF staining was negative for IgG and C3. A second set of biopsies processed at a different laboratory yielded the same result. A diagnosis of bullous scabies was considered. Subsequently, perilesional frozen section DIF for C4d was obtained, which showed strong linear DEJ positivity, confirming the diagnosis of BP. DIF for C4d is widely used in transplant pathology, since C4d is persistent in tissue, versus C3. Our case demonstrates that perilesional frozen section DIF staining for C4d may be positive and diagnostic in BP, even when conventional DIF staining for IgG and C3 is negative.

A case of crusted scabies combined with bullous scabies.

Scabies is a contagious skin disease that causes extremely itching. It is a parasitic disease caused by the mite Sarcoptes scabiei and characterized by polymorphous lesions. Vesicular and bullous lesions in cases of scabies are rather rare. Bullous scabies has a pemphigoid presentation. Crusted scabies, also known as Norwegian scabies, is a rare and severe form of the disease. The large number of mites present in and on the skin cause scabies to be highly contagious. The present study reports a case of crusted scabies combined with bullous scabies, the clinical and histopathological manifestations of which mimicked those of bullous pemphigoid. Direct and indirect immunofluorescence test results were negative. Bullae recurred and persisted despite systemic corticosteroids and antihistamine medication. The patient was successfully treated with 10% sulfur cream and remained free of recurrence during the 12 months of follow-up. Differential diagnosis with bullous pemphigoid and the mechanism of formation of bullae are also discussed.

Bullous scabies failing to respond to glucocorticoids, immunoglobulin, and cyclophosphamide

International Journal of DermatologyVolume 53, Issue 4 p. e265-e266 Correspondence Bullous scabies failing to respond to glucocorticoids, immunoglobulin, and cyclophosphamide Ming-Chun Chen MMS, Ming-Chun Chen MMS Department of Dermatology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, ChinaSearch for more papers by this authorDi-Qing Luo MMS, Di-Qing Luo MMS luodq@mail.sysu.edu.cn diqing.luo@medmail.com.cn Department of Dermatology, Huangpu Hospital of The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, ChinaSearch for more papers by this author Ming-Chun Chen MMS, Ming-Chun Chen MMS Department of Dermatology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, ChinaSearch for more papers by this authorDi-Qing Luo MMS, Di-Qing Luo MMS luodq@mail.sysu.edu.cn diqing.luo@medmail.com.cn Department of Dermatology, Huangpu Hospital of The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, ChinaSearch for more papers by this author First published: 18 October 2013 https://doi.org/10.1111/ijd.12315Citations: 3 Funding sources: None. Conflicts of interest: None. Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article.Citing Literature Volume53, Issue4April 2014Pages e265-e266 RelatedInformation

Bullous scabies in an adult: A case report with review of literature

Scabies is an infestation caused by Sarcoptes scabiei, characterized by polymorphous lesions that may include burrows, papules, nodules, excoriation, and crusts. Vesicular and bullous lesions are rather rare. Bullous scabies is regarded as a distinct subtype of scabies, closely resembling bullous pemphigoid. Here, we report a case of bullous scabies in an adult male and review the literature.

Bullous Scabies Simulating Pemphigoid

Scabies is a contagious infestation affecting subjects of all ages, races, and social conditions. We report a case of a 79-year-old man who developed a bullous pemphigoid-like eruption. He presented to our unit 4 months after the onset of symptoms. An autoimmune bullous disease was suspected. Direct immunofluorescence on a skin specimen and anti-desmoglein 1, anti-desmoglein 3, and anti-bullous pemphigoid antigen 180 were negative. Surprisingly, the histology of a skin lesion demonstrated the presence of scabies, which was successfully treated with benzyl benzoate 20%. The diagnosis of bullous scabies should be considered for any bullous eruptions accompanied by papules and itching resistant to steroid treatment and with negative immunopathologic findings.

Recurrent Bullous Scabies

scabies is a common infestation that usually presents as a pruriginous eruption consisting of erythematous papules, nodules, and excoriations. Diagnosis relies mostly on clinical features, including the identification of scabietic burrows. Several atypical clinical manifestations have been reported; bullous presentations are particularly rare and intriguing. a case of recurrent bullous scabies is reported. an 87-year-old institutionalized woman developed a pruriginous eruption that mimicked bullous pemphigoid. Histopathologic examination revealed blistering at the subepidermal level and a mixed inflammatory infiltrate with numerous eosinophils. Scabies mites were identified on dermoscopy and on skin scrapings, allowing a diagnosis of bullous scabies. Despite effective treatment with topical lindane, failure to control scabies in her institution led to recurrences of her peculiar blistering infestation. Immunofluorescence studies were always negative. these observations underscore the mite's role in the pathogenesis of blister formation and illustrate current challenges in scabies' diagnosis and management.

Bullous Scabies Responding to Ivermectin Therapy

Bullous scabies is a rare disease that is usually diagnosed in elderly patients. The clinical, histological, and immunological findings are identical to those of bullous pemphigoid. In a review of the literature, we found reports of 24 cases. We present a new case of bullous scabies in a 72-year-old man. The lesions responded to treatment with oral ivermectin.

Sarna ampollosa con respuesta terapéutica a la ivermectina

Bullous scabies is a rare disease that is usually diagnosed in elderly patients. The clinical, histological, and immunological findings are identical to bullous pemphigoid. In a review of the literature, we found reports of 24 cases. We present a new case of bullous scabies in a 72-year-old man. The lesions responded to treatment with oral ivermectin.

Bullous scabies in a patient on anticancer therapy

Bullous scabies in a patient on anticancer therapy

Bullous scabies

Bullous scabies is a rare presentation usually occurring in patients who are elderly. Clinical, histologic, and immunofluorescent findings mimic bullous pemphigoid. We report a case of bullous scabies in a 4-year-old boy and review the literature.

Localized Bullous Scabies

A previously unreported form of localized bullous scabies mimicking bullous pemphigoid is described. The patient presented with a localized, severely pruritic erythematous plaque with a cutaneous eruption consisting of several papules and a single tense bulla on an erythematous base. The histologic findings consisted of a subepidermal inflammatory bullous dermatosis with lymphocytes, neutrophils, and many eosinophils, and the results of direct immunofluorescence were negative. Correlation of the clinical course with the histologic and immunofluorescence findings were necessary to establish the diagnosis of infestation by Sarcoptes scabiei.

Bullous urticaria.

The bullous form of urticaria is so uncommon that several dermatologic textbooks in recent years only mention it by name. Hebra⁴stated that the affection developed chiefly on the surface of preexisting wheals, rather than on the surrounding erythematous areola. He differentiated it from pemphigus and bullous erysipelas. Frieboes²observed vesiculating urticaria most frequently on the palms and soles of children and distinguished it from bullous congenital syphilis and scabies. Flandin¹labeled the condition Kaposi's vesicular or bullous urticaria. He wrote that it complicated ordinary urticaria, but that the bullous lesions, which rapidly underwent desiccation and crust formation, were not as numerous as the remainder of urticarial lesions. In his opinion, this condition was most frequently confused with dermatitis herpetiformis and pemphigus. Van der Meiren and Achten,⁶reporting three cases of bullous urticaria, clinically and histologically, thought they were able to demonstrate multilocular intraepidermal