What’s causing these pruritic lesions?

January 23, 2019

Figure 1 Quiz of the Week

A 38-year-old man presents with itchy, scaly lesions on his elbows and small, erythematous papules in the web spaces of his fingers.

What is the most likely diagnosis?

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Image credit: @RamonaNP.

Answer: Scabies

Scabies is caused by the tick Sarcoptes scabiei, that burrows into human skin where it lays its eggs. The inflammation is caused by a type IV hypersensitivity reaction which produces erythema and intense pruritus that is often worse at night. Scabies can be treated with topical or systemic therapy.

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