1921
Volume 95, Issue 3
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645

Abstract

Abstract

Scabies is a common contagious cutaneous disease and usually affects the young, characterized by polymorphous lesions that may present as burrows, pruritic papules, and inflammatory nodules. Bullous scabies (BS) is its rather rare subtype, mimicking bullous pemphigoid. We report a 15-year-old Chinese boy presenting with 1-month history of pruritic bullae on his penile skin, showing poor response to both topical steroids and systemic antihistamines, but cured by sulfur ointment alone. No recurrence occurred in the 5 years of follow-up. We also reviewed the published cases. Up to date, 44 cases, including the present, have been reported. Of them, 30 were male and 14 were female. The age range was from 1 to 89 years old, with a median age of 70.6 years. The bullous lesions may involve the arms, legs, trunk, genitals, feet, buttocks, thighs, neck, inguinal folds, and may even be generalized. Trunk and extremities are the most common involved locations. Facial or mucosa involvement had never been reported. The histological findings present as a subepidermal split with variable inflammatory infiltrate predominantly neutrophils, and eosinophilic spongiosis, or both. Eighteen of 32 patients showed positive deposition of linear-granular IgG or complement 3 alone or in various combinations, and five of 24 patients revealed circulating IgG. All the 40 cases with therapeutic details were cured by antiscabietic remedy. BS always involves the trunk and extremities. It has a predilection for elderlies and males. The treatments for BS are similar to those of classical scabies.

Loading

Article metrics loading...

The graphs shown below represent data from March 2017
/content/journals/10.4269/ajtmh.16-0273
2016-09-07
2019-01-18
Loading full text...

Full text loading...

/deliver/fulltext/14761645/95/3/689.html?itemId=/content/journals/10.4269/ajtmh.16-0273&mimeType=html&fmt=ahah

References

  1. Orkin M, , 1995. Scabies: what is new? Curr Probl Dermatol 22: 105111.[Crossref] [Google Scholar]
  2. Karthikeyan K, , 2007. Scabies in children. Arch Dis Child Educ Pract Ed 92: e65e69.[Crossref] [Google Scholar]
  3. Hengge UR, Currie BJ, Jäger G, Lupi O, Schwartz RA, , 2006. Scabies: a ubiquitous neglected skin disease. Lancet Infect Dis 6: 769779.[Crossref] [Google Scholar]
  4. Hicks MI, Elston DM, , 2009. Scabies. Dermatol Ther (Heidelb) 22: 279292.[Crossref] [Google Scholar]
  5. Heukelbach J, Freldmeier H, , 2006. Scabies. Lancet 367: 17671774.[Crossref] [Google Scholar]
  6. Sunderkötter C, Mayser P, Fölster-Holst R, Maier WA, Kampen H, Hamm H, , 2007. Scabies. J Dtsch Dermatol Ges 5: 424430.[Crossref] [Google Scholar]
  7. Chosidow O, , 2000. Scabies and pediculosis. Lancet 355: 819826.[Crossref] [Google Scholar]
  8. Wendel K, Rompalo A, , 2002. Scabies and pediculosis pubis: an update of treatment regimens and general review. Clin Infect Dis 35: S146S151.[Crossref] [Google Scholar]
  9. Estes SA, , 1982. The diagnosis and management of scabies. Med Clin North Am 66: 955963.[Crossref] [Google Scholar]
  10. Witkowski JA, Parish LC, , 1984. Scabies: a cause of generalized urticaria. Cutis 33: 277279. [Google Scholar]
  11. Rudolph RI, , 1982. Scabies resembling Darier's disease. JAMA 247: 1937.[Crossref] [Google Scholar]
  12. Ackerman AB, Stewart R, Stillman M, , 1975. Scabies masquerading as dermatitis herpetiformis. JAMA 233: 5354.[Crossref] [Google Scholar]
  13. Bean SF, , 1974. Bullous scabies. JAMA 230: 878.[Crossref] [Google Scholar]
  14. Gutte RM, , 2013. Bullous scabies in an adult: a case report with review of literature. Indian Dermatol Online J 4: 311313.[Crossref] [Google Scholar]
  15. Bhawan J, Milstone E, Malhotra R, Rosenfeld T, Appel M, , 1991. Scabies presenting as bullous pemphigoid-like eruption. J Am Acad Dermatol 24: 179181.[Crossref] [Google Scholar]
  16. Rossell LG, Redonnet MS, Millet PU, , 2010. Bullous scabies responding to ivermectin therapy. Actas Dermosifiliogr 101: 8184.[Crossref] [Google Scholar]
  17. Shahab RK, Loo DS, , 2003. Bullous scabies. J Am Acad Dermatol 49: 346350.[Crossref] [Google Scholar]
  18. Ansarin H, Jalali MH, Mazloomi S, Soltani-Arabshahi R, Setarehshenas R, , 2006. Scabies presenting with bullous pemphigoid-like lesions. Dermatol Online J 12: 19. [Google Scholar]
  19. Kaur S, Thami GP, , 2003. Bullous scabies in an adult. Clin Exp Dermatol 28: 9394.[Crossref] [Google Scholar]
  20. Veraldi S, Scarabelli G, Zerboni R, Pelosi A, Gianotti R, , 1996. Bullous scabies. Acta Derm Venereol 76: 167168. [Google Scholar]
  21. Nakamura E, Taniguchi H, Ohtaki N, , 2006. A case of crusted scabies with a bullous pemphigoid-like eruption and nail involvement. J Dermatol 33: 196201.[Crossref] [Google Scholar]
  22. Jena DK, Dash ML, Chhetia R, , 2005. Bullous scabies in a patient on anticancer therapy. Indian J Dermatol Venereol Leprol 71: 5354.[Crossref] [Google Scholar]
  23. Viraben R, Dupre A, , 1989. Scabies mimicking bullous pemphigoid. J Am Acad Dermatol 20: 134136.[Crossref] [Google Scholar]
  24. Ostlere LS, Harris D, Rustin MH, , 1993. Scabies associated with a bullous pemphigoid-like eruption. Br J Dermatol 128: 217219.[Crossref] [Google Scholar]
  25. Parodi A, Saino M, Rebora A, , 1993. Bullous pemphigoid-like scabies. Clin Exp Dermatol 18: 293.[Crossref] [Google Scholar]
  26. Said S, Jay S, Kang J, Liem WH, Jensen JL, Jeffes EWB, III, 1993. Localized bullous scabies: uncommon presentation of scabies. Am J Dermatopathol 15: 590593.[Crossref] [Google Scholar]
  27. Haustein UF, , 1995. Bullous scabies. Dermatology 190: 8384.[Crossref] [Google Scholar]
  28. Slawsky LD, Maroon M, Tyler WB, Miller OF, , 1996. Association of scabies with a bullous pemphigoid-like eruption. J Am Acad Dermatol 34: 878879.[Crossref] [Google Scholar]
  29. Bosch-García R, Arce Calvo MF, Gallardo-Pérez MA, Ruiz del Portal Pérez-Bryan G, Herrera Ceballos E, , 2000. Sarna ampollosa: a propósito de dos casos. Actas Dermosifiliogr 91: 219222. [Google Scholar]
  30. Bornhovd E, Partscht K, Flaig MJ, Messer G, , 2001. Bullous scabies and scabies-triggered bullous pemphigoid. Hautarzt 52: 5661.[Crossref] [Google Scholar]
  31. Serra D, Pedro Reis J, Mariano A, Machado A, Figueiredo A, , 2010. Recurrent bullous scabies. J Cutan Med Surg 14: 175177.[Crossref] [Google Scholar]
  32. Wozniacka A, Hawro T, Schwartz RA, , 2008. Bullous scabies: a diagnostic challenge. Cutis 82: 350352. [Google Scholar]
  33. Marciniak A, Czarnecka-Operacz M, Silny W, Zaba R, Bowszyc-Dmochowska M, , 2009. Bullous scabies: a case report. Postepy Dermatol Alergol 26: 161164. [Google Scholar]
  34. Roxana Stan T, Piaserico S, Bordignon M, Salmaso R, Zattra E, Alaibac M, , 2011. Bullous scabies simulating pemphigoid. J Cutan Med Surg 15: 5557.[Crossref] [Google Scholar]
  35. Chen MC, Luo DQ, , 2014. Bullous scabies failing to respond to glucocorticoids, immunoglobulin, and cyclophosphamide. Int J Dermatol 53: e265e266.[Crossref] [Google Scholar]
  36. Balighi K, Robati RM, Hejazi N, , 2006. A dilemma: bullous pemphigoid-like eruption in scabies or scabies-induced bullous pemphigoid. Dermatol Online J 12: 13. [Google Scholar]
  37. Zhang M, Liao WJ, Li CX, , 2014. A case of bullous scabies [in Chinese]. J Clin Dermatol 43: 484486. [Google Scholar]
  38. Huang MX, Li ZS, Luo DQ, Lin Q, , 2015. Bullous pemphigoid-like eruption subsequent to scabies: bullous scabies or bullous pemphigoid? G Ital Dermatol Venereol 150: 337339. [Google Scholar]
  39. Maan MA, Maan MS, Sohail AM, Arif M, , 2015. Bullous scabies: a case report and review of the literature. BMC Res Notes 8: 254.[Crossref] [Google Scholar]
  40. Akin Belli A, Geyik N, Dervis E, , 2015. A case of bullous scabies misdiagnosed as acquired epidermolysis bullosa. Int J Dermatol 54: e499e501.[Crossref] [Google Scholar]
  41. Su WJ, Fang S, Chen AJ, Shan K, , 2015. A case of crusted scabies combined with bullous scabies. Exp Ther Med 10: 15331535. [Google Scholar]
  42. Shirlene-Jay SS, Kang J, Liem WH, Jensen JL, Jeffes EWB, , 1993. Localized bullous scabies. Am J Dermatol 15: 590593.[Crossref] [Google Scholar]
  43. Kambara T, Takeuchi M, Takahashi I, Takekawa M, Sugita Y, Ishii N, Nakajima H, , 1999. A case of crusted scabies associated with bullous pemphigoid. Hifu 41: 209213. [Google Scholar]
  44. Inoue T, Nomoto M, Arase S, , 2000. A case of Norwegian scabies associated with bullous pemphigoid. Hifu Rinsho 42: 11651168. [Google Scholar]
  45. Brar BK, Pall A, Gupta RR, , 2003. Bullous scabies mimicking bullous pemphigoid. J Dermatol 30: 694696.[Crossref] [Google Scholar]
  46. Clyti E, Beylot-Barry M, Demay O, , 1997. Bullous scabies: a sometimes difficult diagnosis. Nouv Dermatol 16: 218219. [Google Scholar]
  47. Galvany Rossell L, Salleras Redonnet M, Umbert Millet P, , 2010. Bullous scabies responding to ivermectin therapy. Actas Dermosifiliogr 101: 8184.[Crossref] [Google Scholar]
  48. Ezaki C, Hasegawa K, Kiyoshima M, Mori T, , 1994. Crusted scabies with bullous pemphigoid. Rinsho Hifuka 48: 779782. [Google Scholar]
  49. Kurosawa M, Yamamoto S, Higashi K, Ookido M, , 1992. Crusted scabies with bullous eruption (in Japanese). Hifu Rinsho 34: 18831886. [Google Scholar]
  50. Ponce-Navarez E, Przybilla B, , 1981. Bullous scabies in hereditary dystrophic epidermolysis bullosa. Hautarzt 32: 9697. [Google Scholar]
  51. Konishi N, Suzuki K, Tokura Y, Hashimoto T, Takigawa M, , 2000. Bullous eruption associated with scabies: evidence for scabetic induction of true bullous pemphigoid. Acta Derm Venereol 80: 281283.[Crossref] [Google Scholar]
  52. Chung SD, Lin HC, Wang KH, , 2014. Increased risk of pemphigoid following scabies: a population-based matched-cohort study. J Eur Acad Dermatol Venereol 28: 558564.[Crossref] [Google Scholar]
  53. Wang CH, Lee SC, Huang SS, Kao YC, See LC, Yang SH, , 2012. Risk factors for scabies in Taiwan. J Microbiol Immunol Infect 45: 276280.[Crossref] [Google Scholar]
  54. Miller DD, Bhawan J, , 2013. Bullous tinea pedis with direct immunofluorescence positivity: when is a positive result not autoimmune bullous disease? Am J Dermatopathol 35: 587594.[Crossref] [Google Scholar]
  55. Mir F, Cruz-Oliver DM, , 2014. Scabies manifesting as bullous pemphigus in a nursing home resident. J Am Geriatr Soc 62: 12011203.[Crossref] [Google Scholar]
http://instance.metastore.ingenta.com/content/journals/10.4269/ajtmh.16-0273
Loading
/content/journals/10.4269/ajtmh.16-0273
Loading

Data & Media loading...

  • Received : 07 Apr 2016
  • Accepted : 18 May 2016

Most Cited This Month

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error