Infected Scabies

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HISTORY

  • 23 year old heterosexual man
  • Unprotected casual sex 6 weeks previously
  • Presented with 3 days of painful burning penile rash
  • Went to Emergency Department, given valaciclovir for presumed HSV
  • Referred here for review

 

EXAMINATION

  • Numerous small pustules and exfoliation
  • Bilateral inguinal lymphadenitis

 

PROVISIONAL DIAGNOSIS

  • Staphylococcal exfoliation

 

MANAGEMENT

  • Augmentin Duo Forte
  • Review in 3 days

 

AT REVIEW

  • Pain had subsided, but now uncontrollable itching
  • Pustules had dried, and numerous scabietic burrows now obvious
  • Skin scrapings:

Sarcoptes scabiei mite!

 

 

FINAL DIAGNOSIS

  • Scabies with staphylococcal superinfection and exfoliation

 

THE LESSON

  • Just like the texts say: Always consider scabies in cases of genital pyoderma

Dated November, 2007