Hemorrhagic bulla: a rare presentation of scabies

Abstract

Scabies is a contagious skin disorder with multiple presentations, it can also cause nosocomial infection sometimes. Bullous scabies is its rare subtype with male predilection, and typically occurs in the elderly with a median age of 70 years. We herein report a 90-year-old man who was hospitalized in the ward presenting with generalized infection of scabies associated with hemorrhagic bullae on both feet and hands, and leading to a prevalence in the ward. All the lesions including the bullae had excellent response to 10% sulfur ointment alone. No relapse occurred in more than 9 months of follow-up.

Keywords: Association; bulla; hemorrhage; hospital; scabies.

Figure 1

Discrete papules and papulovesicles distributed on the right palm (A), and isolated intact tense hemorrhagic bulla with surrounding erythema measuring approximately 1 cm in diameter on the dorsal aspect of the left foot (B), the fluid from the bulla is demonstrated the blood (the inset) after the bulla is punctured with a needle. The bullous lesion cured without scar left behind after treated with antiscabietics (C).