Scabies surrepticius

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What is Scabies surrepticius?

Scabies surrepticius is a term used to describe all the non classic presentations of scabies.

Surrepticius means concealed.


Scabies surrepticius subtypes


Bullous scabies

Bullous scabies is mostly presented with pruritic vesiculobullous lesions associated with classic scabetic lesions. It is rare and occurs mostly in old patients but it may occurs at any age. Bullous scabies may look like bullous pemphigoid clinically and histopathologically. It is treated as the same way as classic scabies.

Bullous scabies
Bullous scabies

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Patients with tense pruritic bullae that does not respond to topical steroids should be investigated for scabies.


Crusted scabies

Crusted scabies (Norwegian scabies) is a rare highly contagious subtype presents with hyperkeratotic plaques which are heavily infested with mites. Crusted scabies may be localized, affecting only the scalp, face, fingers, toenails or soles. Generalized lymphadenopathy is present in some cases, and blood eosinophilia and elevated IgE levels are common. Pruritus is rare but occasionally may be severe. Crusted scabies is common in immunosuppressed patients, mentally retarded patients and patients with sensory problems.

Crusted scabies
Crusted scabies

Scabies incognito

Scabies incognito is noticed in patients receiving steroids (topical or systemic) which changes the classic picture of scabies. It may be mistaken for other skin diseases

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Nodular scabies

Nodular scabies presents with pruritic persistent nodules which occurs as a hypersensitivity reaction to mite antigens. Nodules are often located at scrotum, genitalia and axilla.


Scalp scabies

Scalp scabies may be mistaken for seborrhoeic dermatitis or dermatomyositis of the scalp. Scalp scabies may be a localized type of crusted scabies.


Hidden scabies

Hidden scabies is difficult to diagnose clinically or histologically . As a result, PCR was used to confirm the diagnosis.

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LCH- like scabies

Scabies with histopathological features of  Langerhans cell histiocytosis (LCH).

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References


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