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October 2001

Recurrent Pruritic Papules in a 74-Year-Old Man

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Arch Dermatol. 2001;137(10):1367-1372. doi:

A 74-year-old white man presented with a 4-month history of a pruritic, remitting and relapsing eruption that began on his abdomen and progressed to his upper and lower extremities, head, and neck. At the time the symptoms began, the patient was a resident in a nursing facility, and his roommate had been diagnosed with scabies. Topical and oral scabicides only partially relieved his pruritus; however, the number and size of his lesions increased.

Physical examination revealed approximately 80 to 90, 1- to 2-cm, reddish brown papules on the trunk and upper and lower extremities, with sparing of the head and neck (Figure 1 and Figure 2). A scabies preparation was negative for mites, ova, and feces. Biopsy specimens of 3 of the representative cutaneous lesions were stained with hematoxylin-eosin (Figure 3 and Figure 4).