Case Number : Case 2322 - 10 May 2019 Posted By: Dr. Richard Carr

Beautiful pigtails! Scabies 

pink pigtail structures, indicative of empty scabies eggshells

Pig tails!!! Wonderful photo.. 

Very nice. Thanks.

Yes, agree, beautiful pigtails. Excellent images

Thank you all.

I wanted to show the pigtails (empty egg shells) as the clue for Scabies. This was a case where initial sections showed a non-specific pattern of lichenification, mild spongiosis, perivascular lymphocytes and eosinophils. I requested levels through the blocks at 150 micron steps and found the nice pigtails and mite (in just one or two) of the step sections. It is always nice to give a specific diagnosis and given the clinical history I thought is was worth exhausting the tissue to find the suspected culprit that is very much alive. Not finding the mite or egg shells would not have excluded "active" scabies of course. Remember one can also suspect scabies from the faecal deposits in the burrow (brown blobs/golden nuggets).