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In this section we have spot diagnoses posted on a daily basis since June 2010, now over 1700! You can review the archived cases and read the suggested diagnoses by users and the final comment by Dr Uma Sundram, the Editor-in-Chief and main spot diagnosis host. Case are uploaded each week day by 10 a.m. UK time with the correct diagnosis will generally be posted at 8 p.m. UK time. Why not view the most recent spot diagnosis and proffer a diagnosis?

Case Number : Case 2960 - 10 November 2021 Posted By: Dr. Hafeez Diwan

Please read the clinical history and view the images by clicking on them before you proffer your diagnosis.
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72-year-old male with history of congenital ichthyosis, now presenting with new full-body erythrodermic rash for 3 weeks, "feels like his skin is on fire" and pruritic. (Images courtesy of Dr. Julie Youngs.)


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Richard Logan

Posted

Yes, I'm sure this is scabies. 

Whether to call it crusted scabies depends on from where the biopsy was taken.  In Norwegian, crusted scabies, most crusting occurs on the hands and feet, with numerous scabies burrows arising elsewhere on sites not normally affected by "normal" scabies.  This biopsy doesn't show any significant crusting which might just be anatomical variation.  There is background psoriasiform epidermal hyperplasia and underlying inflammation, which I suspect are manifestations of the underlying ichthyosis, possibly non-bullous ichthyosiform erythroderma, now aggravated by scabies.

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Meenakshi Batrani

Posted

13 hours ago, Richard Logan said:

Yes, I'm sure this is scabies. 

Whether to call it crusted scabies depends on from where the biopsy was taken.  In Norwegian, crusted scabies, most crusting occurs on the hands and feet, with numerous scabies burrows arising elsewhere on sites not normally affected by "normal" scabies.  This biopsy doesn't show any significant crusting which might just be anatomical variation.  There is background psoriasiform epidermal hyperplasia and underlying inflammation, which I suspect are manifestations of the underlying ichthyosis, possibly non-bullous ichthyosiform erythroderma, now aggravated by scabies.

Agree

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Krishnakumar subramanian

Posted

scabies and Psoriasiform epidermal hyperplasia

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