Pediatric patient develops eosinophilia due to crusted scabies in Puerto Rico

The case highlights the possibility of an underlying immune disorder that needs to be addressed.

The case authors emphasize the fact that scabies should remain in the differential diagnosis in an infant presenting with hypereosinophilia and atypical skin lesions. Photo: Provided by authors of the case through the publication.

Although reports supporting a possible association between eosinophilia and the crusted scabies are limited, a clinical case in Puerto Rico documented the development of the disorder in the midst of a parasitic scabies infestation.

Scabies is caused by Sarcoptes scabiei. This microscopic mite embeds itself in the skin and lays eggs, ultimately triggering an immune response that causes intense itching and a rash.

While the crusted scabies is a rare disease (also called Norwegian scabies) and is a severe form of scabies that often occurs in people who have a weakened immune system, neurological disease, older adults, among others.

It is characterized by thick crusts of skin that contain large numbers of scabies mites and eggs. The crusted scabies It is highly contagious and can be easily spread both through direct skin-to-skin contact and through contaminated items such as clothing, bedding, and furniture.

The registered clinical case maintains that a prospective study establishes the possible between the eosinophilia As a distinctive finding of crusted scabiesand in passing, the case of a 3-month-old neonate with generalized papules and pustules present for 6 weeks, associated with irritability, was presented.

The patient showed generalized yellow to reddish-brown macules, papules, and pustules on the face, scalp, trunk, and extremities, including palms and soles, during his physical evaluation.

An evaluation of the pustular lesions revealed numerous mange mites, eggs, and scybalds. A skin biopsy showed mites in the subcorneal area with a mixed inflammatory infiltrate in the papillary dermis with scattered eosinophils.

The patient was treated with 5% sulfur ointment for 3 consecutive nights and was repeated one week later. The pustules and erythema resolved after 3 weeks.

An elevated eosinophil count in scabies could be attributed to multiple factors, such as a weak immune system, previous use of topical steroids, or an immature immune system in newborns, the case discussion reports.

However, the possibility of an underlying immune disorder needs to be addressed, as there have been reports of 2 infants with scabies and hypereosinophilia.

Likewise, the case authors highlight the fact that scabies should remain in the differential diagnosis in an infant presenting with hypereosinophilia and atypical skin lesions, despite having completed appropriate treatment.

Incidentally, the doctors highlighted that sulfur ointment should be considered as an alternative in children with atypical clinical manifestations that have failed to improve with conventional therapy.

Hypereosinophilic syndrome is a group of blood disorders that occur when you have a large number of eosinophils, white blood cells that play an important role in the immune system.

Access the case here.

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