REPORT OF A CASE
A 30-year-old female physician had a three-month history of numerous erythematous pruritic papules with minimal scaling scattered over her body (Fig 1). Suspecting scabies, she medicated herself with topical lindane lotion without any response, and pruritic lesions continued to appear. No lesions were present between the finger webs and no linear burrows were detected. She was otherwise well and taking no medication. Her medical history did not relate to the current problem.She had noticed hundreds of "insects" between 0.5 and 1.0 mm in length in her bed sheets and she brought some of these for us to examine (Fig 2).What is your diagnosis?
Avian mite dermatitis caused by Ornithonyssus sylviarum (Northern fowl mite).
A sparrow's nest was found in our patient's attic; a vent to the attic was positioned directly above the patient's bed. On removel of the bird's nest and
Gupta AK, Billings JK, Ellis CN. Chronic Pruritus: An Uncommon Cause. Arch Dermatol. 1988;124(7):1105-1106. doi:10.1001/archderm.1988.01670070093030