Skip to content Skip to navigation

Connexions

You are here: Home » Content » Images of Memorable Cases: Case 73

Navigation

Content Actions
  • Download module PDF
  • Add to ...
    Add the module to:
    • My Favorites
    • A lens
    • An external social bookmarking service
    • My Favorites (What is 'My Favorites'?)
      'My Favorites' is a special kind of lens which you can use to bookmark modules and collections directly in Connexions. 'My Favorites' can only be seen by you, and collections saved in 'My Favorites' can remember the last module you were on. You need a Connexions account to use 'My Favorites'.
    • A lens (What is a lens?)

      Definition of a lens

      Lenses

      A lens is a custom view of Connexions content. You can think of it as a fancy kind of list that will let you see Connexions through the eyes of organizations and people you trust.

      What is in a lens?

      Lens makers point to Connexions materials (modules and collections), creating a guide that includes their own comments and descriptive tags about the content.

      Who can create a lens?

      Any individual Connexions member, a community, or a respected organization.

    • External bookmarks
  • E-mail the authors

Recently Viewed

This feature requires Javascript to be enabled.

Tags

(What is a tag?)

These tags come from the endorsement, affiliation, and other lenses that include this content.

Images of Memorable Cases: Case 73

Module by: Herbert L. Fred, MD, Hendrik A. van Dijk

Note: You are viewing an old version of this document. The latest version is available here.

Case_73-pres1-1.jpg Case_73-pres1-2.jpg

Case_73-pres1-3.jpg Case_73-pres1-4.jpg

This 65-year-old woman presented with an intensely pruritic, month-long skin rash that started beneath her right breast, then spread quickly to involve multiple sites, including her face. Some of the lesions were maculopapular, others were psoriasiform, and still others were solitary, rounded, and erythematous. She spent six weeks in the hospital undergoing studies before the diagnosis finally emerged.

73. Scabies

A skin biopsy shortly after admission showed nonspecific findings. A repeat biopsy five weeks later uncovered numerous Sarcoptes scabiei mites. After several courses of scabicidal therapy, the rash resolved. But the story didn’t end there.

Thirty-five hospital workers acquired scabies from this patient. The incubation period for those virgin cases ranged from five to 11 days, a distinctly shorter time frame than the 10 days to a month or more cited in textbooks. Many other personnel who came in contact with this patient never got the disease, including her personal physician, who examined her twice daily. A consultant, however, who had had scabies as a medical student, acquired it from this patient and became symptomatic 24 hours after examining her.

Observations in this case teach several lessons: 1) in some patients, diagnosing scabies requires more than one attempt; 2) susceptibility to scabies varies considerably; 3) the incubation period for virgin cases can be much shorter than what the textbooks cite; 4) in cases of repeat infection, the incubation period is only 24 to 72 hours; and 5) any unexplained, persistent, intensely pruritic skin rash should be considered as scabies until proved otherwise.

Comments, questions, feedback, criticisms?

Send feedback