An Atypical Presentation of Scabies

Arezki Izri Parasitology-Mycology Department, Avicenne Hospital, AP-HP, Paris 13 University, Bobigny, France;
Unité des Virus Émergents (UVE: Aix-Marseille Univ-IRD 190-Inserm 1207-IHU Méditerranée Infection), Marseille, France

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Mohammad Akhoundi Parasitology-Mycology Department, Avicenne Hospital, AP-HP, Paris 13 University, Bobigny, France;

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A 45-year-old woman was referred for foot pain of 3 days duration that impaired walking. Clinical examinations did not reveal any skin abnormalities other than on the plantar aspect of the left foot, where a blister with a linear burrow typical of scabies. Microscopic examination of skin scrapings showed a female Sarcoptes scabiei mite under 100× magnification. Treatment with biseptin (antiseptic lotion) and ivermectin (200 µg/kg, in first and tenth days) led to a favorable outcome 2 weeks later. Human scabies, a skin infestation caused by Sarcoptes scabiei var. hominis mite, occurs worldwide in all ethnic groups and socioeconomic levels.1,2 It spreads by skin-to-skin contact.3 The mites are usually found between the fingers, wrists or genitals.4 Nevertheless, they can appear anywhere on the body and lesions can be exacerbated by immunosuppression. The infested location (plantar) and the clinical manifestation as demonstrated here are uncommon. Clinicians should be aware of such unusual clinical signs and symptoms resulting from Sarcoptes infestation (Figure 1).

Figure 1.
Figure 1.

An atypical presentation of scabies. This figure appears in color at www.ajtmh.org.

Citation: The American Journal of Tropical Medicine and Hygiene 105, 6; 10.4269/ajtmh.21-0714

REFERENCES

  • 1.↑

    Chosidow O, 2006. Clinical practices. Scabies. N Engl J Med 354: 1718–1727.

  • 2.↑

    Walton SF, Currie BJ, 2007. Problems in diagnosing scabies, a global disease in human and animal populations. Clin Microbiol Rev 20: 268–279.

  • 3.↑

    Bernigaud C, Chosidow O, 2018. La gale [Scabies]. Rev Prat 68: 63–69.

  • 4.↑

    Chandler DJ, Fuller LC, 2019. A review of scabies: an infestation more than skin deep. Dermatol 235: 79–90.

Author Notes

Address correspondence to Mohammad Akhoundi, Parasitology-Mycology Department, Avicenne Hospital, AP-HP, Bobigny, France, 125, route de Stalingrad, 93009 Bobigny cedex, France. E-mail: m.akhoundi@yahoo.com

Disclosure: Written informed consent was obtained from the patient for publication of this case report.

Author contributions: Study design: AI, MA; Data collection: AI, MA; Writing and overview: AI, MA. All co-authors have read and confirmed the manuscript.

Authors’ addresses: Arezki Izri and Mohammad Akhoundi, Hospital Avicenne, Parasitology and Mycology, Bobigny, France, E-mails: arezki.izri@aphp.fr and m.akhoundi@yahoo.com.

  • 1.

    Chosidow O, 2006. Clinical practices. Scabies. N Engl J Med 354: 1718–1727.

  • 2.

    Walton SF, Currie BJ, 2007. Problems in diagnosing scabies, a global disease in human and animal populations. Clin Microbiol Rev 20: 268–279.

  • 3.

    Bernigaud C, Chosidow O, 2018. La gale [Scabies]. Rev Prat 68: 63–69.

  • 4.

    Chandler DJ, Fuller LC, 2019. A review of scabies: an infestation more than skin deep. Dermatol 235: 79–90.

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