Scabious erythroderma – a rare clinical variant of scabies

Abstract

Background: Erythroderma (exfoliative dermatitis) is an emergency condition in dermatology in which not less than 90% of skin surface is affected. The presenting features are erythema, skin scaling and itching, fever and lymphadenopathy. The most common cause of erythroderma is a preexisting dermatosis (psoriasis, atopic dermatitis, eczema, seborheic dermatitis, lichen rubra pilaris, lichen planus, pemphigus foliaceous), drug reactions, lymphoma, leukemia and visceral neoplasias. Erythroderma is a diagnostically relevant presenting feature of Norwegian scabies. The aim of investigation: Is to describe clinical peculiarities of scabious erythroderma as a special rare form of scabies, to assess the number of scabies mites on the patient and in his/her environment and to work out the criteria of differential diagnosis with Norwegian scabies. Material and methods: We examined 5 patients with scabies and erythroderma as the main presenting feature. All patients were women aged from 42 to 89 years. The disease duration was from 8 months to 1 year. The causes of erythroderma were variable. Clinical and paraclinical methods of investigation alongside with dermatoscopy and microscopy were used. Results This is the description of a rare clinical form of scabies, scabious erythroderma. It is based on the analysis of the 5 cases of scabies, whose main clinical manifestation is diffuse erythroderma. The diagnostic criterias of scabious erythroderma and differential diagnosis of Norwegian scabies are given. The invasive potential of this form of the disease on the patient and beyond is evaluated for the first time.

Norwegian scabies: the realities of our time

“…Одним из основных клинических критериев НЧ является эритродермия. Если при генерализованной эритродермии паразитарного происхождения отсутствуют корки, то эта форма заболевания называется скабиозной эритродермией [29].…”

Editorial comment

“…Many drugs are implicated as a cause of erythroderma, which include: sulphonamides, penicillin, isoniazid, antimalarial, allopurinol, phenytoin, omeprazole, captopril, vancomycin, infliximab, streptomycin, PAS, pyrazinamide, ethambutol, and rifampicin [5][6][7][8][9]. Scabies also implicated as a cause of erythroderma [10][11][12]. Jose et al [12], in an epidemiological study on erythroderma in India found that psoriasis is the common cause of erythroderma (38.23%), followed by the drug induced (20.59%), while atopic dermatitis, irritant dermatitis, pityriasis rubra pilaris, scabies, congenital ichthyosiform, pemphigus foliaceous, systemic lupus erythematosus and T. corporis form 5.88% for each.…”