Case Report: Scabies Invading Gingival Tissue

Abstract

Non-plaque-induced lesions may occur on the gingiva as medical disorders or manifestations of systemic conditions. Scabies is a parasitic infection caused by Sarcoptes scabiei. Here, we present the first case of oral scabies reported in the literature located on the gingiva in a 43-year-old woman. She was admitted to the hospital complaining of an ulcerative lesion on the gingiva with unknown duration, with a suggestive diagnosis of pemphigoid. A diagnosis of scabies infestation was made based on the visualization of eggs and larvae/nymph forms. The treatment consisted of 100 mg of ivermectin (three times per day for 15 days), supplemental oral hygiene with chlorhexidine, and extensive cleaning. The follow-up was made 30 days after treatment with ivermectin. The patient did not report side effects, with skin and oral lesions completely healed. Based on this, we need to perform a thoughtful ectoscopy examination and be alert to signs that indicate unusual causes to diagnose correctly and choose the appropriate treatment.

Figure 1.

(A–D) Ulcerative and granular lesions affecting anterior marginal gingival tissue on both arch and crusty lesions on the hands, feet, and chin and vitiligo manifestations. (E–H) Healed skin and mucosal lesions 30 days after completion of therapy. This figure appears in color at www.ajtmh.org.

Figure 2.

(A–B) Cytological smear revealing inflammatory infiltrates, larvae/nymphs, dorsal surface structures, and eggs. (C–D) Histological features revealed scabies feces, eggs, and bristles. This figure appears in color at www.ajtmh.org.