A case of crusted scabies with a bullous pemphigoid-like eruption and nail involvement

The Journal of Dermatology
Eri NakamuraNoriko Ohtaki

Abstract

We report a case of a 71-year-old man infected at a nursing home who developed a bullous pemphigoid-like eruption with nail involvement. He was diagnosed by his family doctor as suffering from eczema and was treated with topical corticosteroids, then blisters started appearing. He was next diagnosed as suffering from bullous pemphigoid and treated with oral prednisolone, which worsened his condition. He was finally diagnosed as having crusted scabies with bullous pemphigoid-like eruptions and nail involvement at our clinic. He was then prescribed oral ivermectin (two doses of 12 mg ivermectin with a 1-week interval) and topical lindane (1%gamma-BHC in petrolatum) for scabies with 5% salicylic acid in plastibase as an additional treatment for the crusted lesions on his soles. He showed remarkable improvement in 2 weeks, and his nails showed complete recovery after 7 weeks of occlusive dressing treatment with 1%gamma-BHC. One and a half years later, the patient showed no sign of a recurrence of scabies. The histology of a blister taken from this patient was similar to that of bullous pemphigoid. Direct immunofluorescence showed immunoglobulin (Ig)G and C3 deposition at the dermoepidermal junction similar to that of bullous pemphi...Continue Reading

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Citations

Dec 2, 2015·Experimental and Therapeutic Medicine·Wen-Jing SuKui Shan
Mar 25, 2009·Journal of the European Academy of Dermatology and Venereology : JEADV·A Nofal
Aug 1, 2015·International Journal of Dermatology·Asli Akin BelliEmine Dervis
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