Korean J Dermatol.  2014 Aug;52(8):563-566.

Bullous Scabies with Bullous Pemphigoid

• Kang JH
• Lee JH
• Kim TY

Abstract

We report a rare case of bullous scabies with bullous pemphigoid in a 59-year-old male patient. He presented with a 9-month history of exhibiting multiple, variable-sized, red-to-brown, pruritic cutaneous patches, and papules with tense bullae on his whole body. A direct smear of the bullous lesions was performed and was negative for scabies mites. Histopathologic findings (hematoxylin and eosin staining) revealed Sarcoptes scabiei in the stratum corneum. There were sub-epidermal blisters with massive eosinophil and lymphocyte infiltration in the epidermis and upper dermis. Direct immunofluorescence microscopy showed linear deposition of IgG at the dermo-epidermal junction. Indirect immunofluorescence microscopy of samples acquired for the salt-split skin test showed linear IgG deposition in the epidermis. Skin lesions improved after the patient was treated with an anti-scabietic and steroids.

Keyword

Bullous pemphigoid; Bullous scabies

MeSH Terms

Blister
Dermis
Eosine Yellowish-(YS)
Eosinophils
Epidermis
Fluorescent Antibody Technique, Direct
Fluorescent Antibody Technique, Indirect
Humans
Immunoglobulin G
Lymphocytes
Male
Microscopy
Middle Aged
Mites
Pemphigoid, Bullous*
Sarcoptes scabiei
Scabies*
Skin
Skin Tests
Steroids
Transcutaneous Electric Nerve Stimulation
Eosine Yellowish-(YS)
Immunoglobulin G
Steroids