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April 9, 1982

Scabies Resembling Darier's Disease

Author Affiliations

Wyomissing, Pa

JAMA. 1982;247(14):1937. doi:10.1001/jama.1982.03320390021019

To the Editor.—  Several years ago we reported a case of scabies in an immunosuppressed host that closely simulated Darier's disease.1 The patient had recently undergone a renal transplant and had been on a maintenance regimen of azathioprine and prednisone. A florid, scaling, papular eruption developed during several weeks that was clinically identical to Darier's disease. Biopsy specimens and skin scrapings showed a scabetic infestation. We believed that the highly atypical presentation, which had several features that were found in Norwegian scabies, was probably due to a decreased inflammatory response as a result of the immunosuppression and which allowed a spectacular proliferation of the mites on the skin surface.The clinical features found in our patient simulated almost exactly those of Darier's disease, and indeed that was the working diagnosis until the biopsy showed the histopathological findings of scabies. I think that the recently reported case (1981; 246:2608) and