Localised genital Norwegian scabies in an AIDS patient

Perna, Ashley G.; Bell, K; Rosen, Theodore

doi:10.1136/sti.2003.002048

Cited by 28 publications

(16 citation statements)

References 8 publications

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“…Focal, crusted lesions have been reported simulating actinic keratoses, 7 crusted herpes, 3 plantar keratomas, 8 and plaques on the toes, toe nails and toe webs 9 . Localized penile lesions have also been described, 6,10 but crusted lesions of the vulva seem to be very unusual, as we were not able to find any other case reported.…”

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confidence: 73%

Crusted scabies of the vulva

Bakos¹,

Reusch²,

D'elia³

et al. 2007

Acad Dermatol Venereol

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the UVA range, which normalized after cessation of flutamide treatment, while UVB-MED was within the normal range. Photopatch testing, performed with flutamide 10 and 20% in acetone and vaseline, showed positive results.Flutamide is a non-steroidal anti-androgen used for the hormonal treatment of prostatic cancer, while its photosensitizing capacity is well known. Reports of vitiliginous lesions as sequels of flutamide-induced photosensitive dermatitis have been rare. 1 In vitro , flutamide, the spectrum of action of which appears to be in the UVA-range, showed a photohaemolytic effect on human erythrocytes and induced lipid peroxidation. 2 Like us, other authors also found a decreased MED. 3,4 Photosensitivity to flutamide was also demonstrated by photopatch testing, although to date there seems to be no consensus regarding the nature of vehicle and the concentration of flutamide to be used. Vilaplana et al . 5 and Jiménez et al . 6 found positive photopatch tests within the UVA-and UVB-range using flutamide, as we did, dissolved at 10 and 20% in acetone. Positive photopatch tests were also determined using flutamide in petrolatum 4 and in 50% propylene glycol and 50% ethanol. 7 The development of vitiligo after application of photosensitizing drugs needs to be distinguished from contact vitiligo following exposure to depigmenting chemicals like hydroquinone or phenole. However, the pathogenetic mechanisms are not yet clearly understood. Although there are reports of vitiligo-like lesions following systemic treatment like PUVA therapy 8,9 or promethazine, 10 to date only two reports of residual vitiligo following approximately 2 months of photosensitive reactions to flutamide have been published. Meanwhile, in the case reported by Vilaplana et al ., 5 vitiliginous lesions decreased by about 50% within 9 months under systemic treatment with a hydrophilic extract of polypodium leucotomos and topical application of phenylalanine 10% gel and corticosteroids. Jiménez et al . 6 described a slow but progressive, and in some parts almost complete repigmentation within 8 months of treatment with polypodium leucotomos and narrow-band UVB phototherapy in another case of widespread vitiligo following flutamide-induced exfoliative dermatitis. EditorA 25-year-old woman, infected with human immunodeficiency virus (HIV) since 1994 and with a past history of pulmonary tuberculosis, pneumocystosis, cytomegalovirus (CMV) retinitis, ' in situ ' carcinoma of the cervix, and pelvic inflammatory disease, presented with a 2-month history of a widespread itchy eruption all over the skin. She had been treated previously with topical monosulphiram, menthol lotions, and 1% lindane, without any relief of symptoms. In recent months she had had systemic courses of cotrimoxazole and prednisone for Pneumocystis carinii , gancyclovir for CMV infection, and a combination of azydothimidine, indinavir, stavudine and lamivudine for HIV infection.Viral load and CD4 count were not available from her records.

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confidence: 73%

Crusted scabies of the vulva

Bakos¹,

Reusch²,

D'elia³

et al. 2007

Acad Dermatol Venereol

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“…The lesions in Norwegian scabies are classically distributed on the extremities, scalp, back, face and around the nailfolds. Our patient’s presentation of thickly hyperkeratotic plaque localized to the glans penis has not yet been reported in an immunocompetent patient 3 …”

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confidence: 79%

Norwegian (crusted) scabies of glans penis in an immunocompetent patient

Bongiorno¹,

Ferro²,

Aricò³

2009

British Journal of Dermatology

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References1 Ragoowansi R, Cornes PG, Moss AL, Glees JP. Treatment of keloids by surgical excision and immediate post-operative single-fraction radiotherapy. Plast Reconstr Surg 2003; 111:1853-59. 2 Bischof M, Krempien R, Debus J, Treiber M. Postoperative electron beam radiotherapy for keloids: objective findings and patient satisfaction in self-assessment. Int J Dermatol 2007; 46:971-5. 3 Ogawa R, Mitsuhashi K, Hyakusoku H, Miyashita T. Postoperative electron-beam irradiation therapy for keloids and hypertrophic scars: retrospective study of 147 cases followed for more than 18 months. Plast Reconstr Surg 2003; 111:547-53. 4 Van de Kar AL, Kreulen M, van Zuijlen PP, Oldenburger F. The results of surgical excision and adjuvant irradiation for therapyresistant keloids: a prospective clinical outcome study. Plast Reconstr Surg 2007; 119:2248-54. 5 Travis LB, Hill DA, Dores GM et al. Breast cancer following radiotherapy and chemotherapy among young women with Hodgkin disease. JAMA 2003; 290:465-75. 6 van den Belt-Dusebout AW, de Wit R, Gietema JA et al. Treatmentspecific risks of second malignancies and cardiovascular disease in 5-year survivors of testicular cancer. J Clin Oncol 2007; 25:4370-8. 7 Mettler FA, Hempleman LH. Breast cancer in women treated with X-rays for acute postpartum mastitis; a pilot study. J Natl Cancer Inst 1969; 43:803-11. 8 Weiss HA, Darby SC, Doll R. Cancer mortality following X-ray treatment for ankylosing spondylitis. Int J Cancer 1994; 59:327-38. 9 Botwood N, Lewinski C, Lowdell C. The risks of treating keloids with radiotherapy. Br J Radiol 1999; 72:1222-4. 10 Bilbey JH, Muller NL, Miller RR, Nelems B. Localised fibrous mesothelioma of pleura following external ionizing radiation therapy. Chest 1988; 94:1291-2.

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“…[6] Firmly adherent crusts are creamy, gray, yellow-brown, or yellow-green in color. It can also present as warty dermatosis of the hands and feet, dystrophic nails with subungual hyperkeratosis and debris.…”

Section: Discussionmentioning

confidence: 99%

Crusted Scabies: Presenting as erythroderma in a human immunodeficiency virus-seropositive patient

Kulkarni

Shah

Patel

et al. 2016

Indian J Sex Transm Dis

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Crusted scabies is a rare manifestation of scabies characterized by uncontrolled proliferation of mites in the skin. It is common in patients with sensory neuropathy, mentally retarded persons and in patients who are immunosuppressed. Further, crusted scabies can rarely present as erythroderma (<0.5% cases) necessitating a high index of suspicion for its diagnosis. Because of its rare occurrence, we are reporting a case of crusted scabies presenting as erythroderma, in a human immunodeficiency virus seropositive patient.

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Localised genital Norwegian scabies in an AIDS patient

Cited by 28 publications

References 8 publications

Crusted scabies of the vulva

Crusted scabies of the vulva

Norwegian (crusted) scabies of glans penis in an immunocompetent patient

Crusted Scabies: Presenting as erythroderma in a human immunodeficiency virus-seropositive patient

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