The patient, a 33-year-old man presented with one month history of severe generalized pruritus over the trunk. There was no fever. He had a history of exposure with CSW several weeks ago. He was otherwise well.
Examination of the skin showed extensive distribution of discrete erythematous papules 1-2mm diameter on the back of the lower trunk, periumbilical area, dorsum of hands, and thighs bilaterally. Excoriations were noted over the papules. There were no ulcers or erosions. Examination of the mouth and genitalia were normal. The lesions spares the face.
HIV screen negative
Hb 16.1gm%
TWBC 11 700 (N70%, L19%, M6%, E5%)
ESR 2 mm/hr
RBS, LFT and renal function normal
VDRL negative
I suspect scabies would be an important diagnosis to consider and exclude. Occasionally prurigo and pruritic papular eruption of HIV can present like this too. A skin biopsy is being contemplated for him. Any thoughts on this patient?
Examination of the skin showed extensive distribution of discrete erythematous papules 1-2mm diameter on the back of the lower trunk, periumbilical area, dorsum of hands, and thighs bilaterally. Excoriations were noted over the papules. There were no ulcers or erosions. Examination of the mouth and genitalia were normal. The lesions spares the face.
HIV screen negative
Hb 16.1gm%
TWBC 11 700 (N70%, L19%, M6%, E5%)
ESR 2 mm/hr
RBS, LFT and renal function normal
VDRL negative
I suspect scabies would be an important diagnosis to consider and exclude. Occasionally prurigo and pruritic papular eruption of HIV can present like this too. A skin biopsy is being contemplated for him. Any thoughts on this patient?
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