Article Category:
Research Article

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

Feng-Zeng Li Department of Dermatology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China

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Meng Jia Department of Dermatology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China

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Ke-Jun Chen Department of Dermatology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China

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Qian Ye Department of Dermatology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China

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Sheng Fang Department of Dermatology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China

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DOI:
https://doi.org/10.4269/ajtmh.21-0516
Volume/Issue:
Volume 105: Issue 6
Page(s):
1798–1802
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ABSTRACT.

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.

Author Notes

Address correspondence to Sheng Fang, Department of Dermatology, the First Affiliated Hospital of Chongqing Medical University, No. 1 Youyi Rd., Yuzhong District, Chongqing 400016, China. E-mail: fangshengderm@163.com

Disclosure: Ethical approval was provided by the Medical Ethics Committee, the First Affiliated Hospital of Chongqing Medical University (Reference number: 2020-259).

Authors’ addresses: Feng-Zeng Li, Meng Jia, Ke-Jun Chen, Qian Ye, and Sheng Fang, Department of Dermatology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China, E-mails: sdlfz2008@126.com, mengjiaderm@yeah.net, ckj1995@yeah.net, yeqian0330@163.com, and fangshengderm@163.com.

Copyright:
© The American Society of Tropical Medicine and Hygiene 2021
Received:
10 May 2021
|
Accepted:
17 Jul 2021
|
Published Online:
07 Sep 2021
Cover The American Journal of Tropical Medicine and Hygiene
The American Journal of Tropical Medicine and Hygiene
Print ISSN:
0002-9637
Online ISSN:
1476-1645
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