PMC6346783_01
Scalp at hospital admission
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On physical examination, she presented erythematous-desquamative plaques and an adherent grey scale with a thick crust with fissures on the scalp with no hair (Fig. 1), palmar keratodermia (Fig. 2) and small erythematous plaques on the forearms, chest and back, associated with itchy lesions.
Histological examination of a skin fragment (haematoxylin and eosin stain). Left image: view of the skin with scabies mites seen on the surface.. Right image: closer view of the scabies mites
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The immunophenotyping study was inconclusive and histological examination of the skin revealed marked hyperkeratosis with abundant arthropod parasites compatible with S. scabiei (Fig. 3).
Scalp 10 days after treatment initiation
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The patient's skin lesions gradually improved (Fig. 4) and she was discharged at the end of treatment.
Scalp and palmar surface 6 months after treatment completion
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The patient showed no signs of clinical relapse 6 months after treatment completion (Fig. 5).