Hesari Roksana, Schur Nina, Tyndall Nicholas, Chuchla Thaddeus, Gazy Nicky
Osteopathic Medicine, Lake Erie College of Osteopathic Medicine, Bradenton, USA.
Dermatology, Western University of Health Sciences, Pomona, USA.
Cureus. 2023 Dec 18;15(12):e50744. doi: 10.7759/cureus.50744. eCollection 2023 Dec.
Scabies, a common and highly contagious skin infestation, is caused by the mite var. . Identifying individuals with scabies often poses a diagnostic challenge, as its clinical features resemble other dermatologic conditions such as drug reactions, atopic dermatitis, and contact dermatitis. Furthermore, the cutaneous manifestations arise from delayed-type immunologic reactions to the mites and their byproducts, allowing some individuals to carry the mite without showing symptoms. The significant transmissibility of scabies, along with the potential for asymptomatic carriers, creates multiple treatment hurdles for cohabiting individuals, as the failure to treat all close contacts can result in re-infestation. This report presents the case of a 46-year-old Vietnamese male who suffered from a worsening erythematous, scaly, and pruritic rash for four months. Despite being prescribed topical corticosteroids by three different dermatologists, his rash persisted. Upon thorough evaluation, scabies was diagnosed. The patient was treated with scabicidal agents, which initially alleviated his symptoms; however, three weeks later, his symptoms resurfaced. Further investigation revealed that his wife was an asymptomatic carrier who had not received treatment. This case highlights the clinical features, pathogenesis, and treatment options for scabies while emphasizing the importance of promptly identifying and treating all close contacts.
疥疮是一种常见且具有高度传染性的皮肤寄生虫感染，由疥螨变种引起。疥疮患者的诊断往往具有挑战性，因为其临床特征与其他皮肤病相似，如药物反应、特应性皮炎和接触性皮炎。此外，皮肤表现是对螨虫及其副产物的迟发型免疫反应所致，这使得一些携带螨虫的人没有症状。疥疮的高传染性以及无症状携带者的存在，给同居者带来了多重治疗障碍，因为未能治疗所有密切接触者可能导致再次感染。本报告介绍了一名46岁越南男性的病例，他患有逐渐加重的红斑、鳞屑性瘙痒皮疹达四个月。尽管三位不同的皮肤科医生都给他开了外用皮质类固醇药物，但他的皮疹仍持续存在。经过全面评估，诊断为疥疮。患者接受了杀疥剂治疗，症状最初有所缓解；然而，三周后，症状再次出现。进一步调查发现，他的妻子是无症状携带者，未接受治疗。该病例突出了疥疮的临床特征、发病机制和治疗选择，同时强调了及时识别和治疗所有密切接触者的重要性。
