Arslan Hakan, Gündüz Özgür
Department of Dermatology, Dr Sami Ulus Maternity and Children's Hospital, Ankara, Turkey.
Department of Dermatology, Kırıkkale University Faculty of Medicine, Kırıkkale, Turkey.
Postepy Dermatol Alergol. 2023 Jun;40(3):432-436. doi: 10.5114/ada.2023.128976. Epub 2023 Jul 15.
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.
大疱性疥疮（BS）是一种罕见的非典型疥疮表现，好发于老年男性。BS的发病机制尚未完全明确；继发感染、瘙痒引起的摩擦、自体湿疹化、螨虫溶解酶的直接损伤、疥疮蛋白与基底膜带抗原的交叉反应被认为是可能的原因。
明确小儿BS病例的临床特征，小儿BS是一种极为罕见的疥疮亚型。
这是一项对两个三级医疗中心所见小儿BS病例的回顾性研究。对先前描述的细菌培养、抗菌谱和随访记录进行回顾性调查。纳入根据“国际疥疮控制联盟（IACS）”确诊的伴有大疱的疥疮病例。所有病例连续3天每天使用10%硫磺软膏治疗，共两个疗程。病例的家庭成员也同时接受治疗。根据抗菌谱结果，对急性期反应物升高的患者加用全身抗生素。获得了患者家长的知情同意。
纳入5例BS病例。3例为男性，2例为女性。4例金黄色葡萄球菌培养阳性，1例A组β溶血性链球菌大疱培养阳性。所有病例在局部使用10%硫磺软膏后症状迅速完全缓解。
小儿BS是一种极为罕见的疥疮类型。细菌继发感染在大疱形成中起关键作用。10%硫磺软膏是治疗小儿BS的一种高效治疗选择。
