Monday, October 23, 2017

Case of the Week 465

This week's case is of an elderly woman with thick cutaneous lesions involving the dorsal and ventral aspects of her feet including her toes. There is no associated pain or itching. A sample of the thickened skin was sent to the parasitology laboratory for further examination. Below is what we received; it measured approximately 5 cm in greatest dimension:

Microscopic examination of a small portion of this material showed the following:


Identification? What is the most likely clinical diagnosis?

9 comments:

Wolfman said...

Scabies! Sarcoptes scabiei with fecal pellets.

Idzi P. said...

Definitely scabies!
I am not a doctor, but I would dare say it's probably Norwegian (or crusted) scabies... Is the patient immunocompromised in any way?

Anonymous said...

Sarcoptes scabiei and its scybala. A little bit unusual that it infests the ventral aspect of the foot,

Florida Fan

Anthony Rochester said...

Looks like scabies but doesn't scabies cause intense itching?

Unknown said...

Morphological is look like Sarcoptes scabiei, but this parasite cause itch!! Maybe the paciente have lost of sensitivity for diabetes???

Sugar Magnolia said...

Norwegian scabies caused by Sarcoptes scabiei. The thick crust formed and lack of intense itching is typical of this particular manifestation of scabies, and unlike the more common, "itchy" form of scabies, Norwegian (crusted) scabies affects immunocompromised and/or elderly patients (note this patient is elderly).

Anonymous said...

I also think it's Norwegian scabies, and I agree with Sugar Magnolia's explanation.

Atiya Kausar said...

Norwegian scabies I think

ali mokbel said...

And the answer is....