A CLINICAL CASE OF SCABIES WITH SECONDARY STREPTOCOCCAL INFECTION

Introduction and Objective: Scabies is a worldwide common skin infestation that affects people of all races and social classes. It’s caused by the human itch mite Sarcoptes scabiei hominis and it’s spread by direct contact with an infested individual. Its prevalence is estimated to be 300 million cases worldwide. Risk factors include being in the same household, young children, the elderly, institutionalization or overcrowded living conditions. Diagnosis is based on history and clinical findings including intense pruritus and linear erythematous burrows, particularly on the extremities. Treatment with a topical scabicide is usually effective but several complications of this condition can occur. We present a case of scabies with secondary streptococcal infection. Method: Data gathered from patient’s interviews, physical examination and clinical records. Literature review regarding scabies was also performed. Results and Conclusions: 56-year-old man, melanodermic, married, working as a construction worker in Switzerland. Scheduled an appointment with his Family Physician in Portugal, complaining about severe itching on his arms, abdomen and legs that worsened at night for the last 2 months. Recently presented infected lesions on his legs. Seen by another doctor a month before, he was prescribed with emollient cream, topical and oral corticosteroids. The diagnosis of scabies with secondary streptococcal infection on his legs was made and the patient started a scabicide and an antibiotic with clinical improvement. This case shows the importance of including the diagnosis of scabies in the differential diagnosis of pruritus, as well as the patient’s cultural and epidemiologic context in our clinical practice.