ABSTRACT

Nodular scabies is a hypersensitivity reaction to the antigens of “Sarcoptes scabiei hominis” characterized by erythematous, red-brown colored, itchy, multiple nodular lesions frequently in intertriginous regions. Herein, a 6-month-old infant with nodular scabies mimicking clinically and histopathologically urticaria pigmentosa is presented and the differential diagnosis is discussed. On the dermatological examination of a 6-month old boy presented with pruritic, red swellings on his scalp, neck and trunk; widespread erythematous papules and pustules, multiple reddish-brown nodules were seen. Darier sign were positive on the nodular lesions. The histopathological examination made with the pre-diagnosis of urticaria pigmentosa and nodular scabies; revealed mixed type inflammatory cell infiltration including eosinophil, neutrophil lymphocyte and a few mast cells in the interstitial and perivascular regions in the dermis. Scabies treatment was started for the patient diagnosed with nodular scabies, after the clinical and histopathological evaluation by excluding the other differential diagnosis. The diagnosis of nodular scabies was confirmed with excluding the other diseases in differential diagnosis as a result of the complete remission at the end of the second month. In the differential diagnosis of the pruritic, red-brown papules and nodules in infants younger than two years old, nodular scabies should always be kept in mind and histopathological examination should be performed for the definite diagnosis.