Localized Bullous Scabies: Uncommon Presentation of Scabies

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A previously unreported form of localized bullous scabies mimicking bullous pemphigoid is described. The patient presented with a localized, severely pruritic erythematous plaque with a cutaneous eruption consisting of several papules and a single tense bulla on an erythematous base. The histologic findings consisted of a subepidermal inflammatory bullous dermatosis with lymphocytes, neutrophils, and many eosinophils, and the results of direct immunofluorescence were negative. Correlation of the clinical course with the histologic and immunofluorescence findings were necessary to establish the diagnosis of infestation by Sarcoptes scabiei.

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