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December 1991

Flame Figures in Scabies: A Case Report

Author Affiliations

Department of Dermatology University of Pittsburgh 3601 Fifth Ave Pittsburgh, PA 15213

6810 Castor Ave Philadelphia, PA 19149

Departments of Dermatology and Pathology Thomas Jefferson University Hospital 111 S 11th St Philadelphia, PA 19107

Arch Dermatol. 1991;127(12):1850-1851. doi:10.1001/archderm.1991.04520010092023

To the Editor.  —Flame figures were first described by Wells in 1971 and are an important, but not pathognomonic, histopathologic criterion for Wells' syndrome.1 Since their original description, flame figures have been found in a variety of conditions other than Wells' syndrome. These conditions include arthropod bite reactions from ticks, bees, fleas, and spiders1,2; hematogenous disorders, including lymphoma, pseudolymphoma, leukemia, and polycythemia vera; inflammatory conditions, including eczema, prurigo, bullous pemphigoid, and herpes gestationis2; chronic urticaria; respiratory tract infections, such as sinusitis and Streptococcal pharyngitis; drug administration and surgical procedures; dermatophyte infections and sporotrichosis1; and parasitic infections, including toxocariasis and onchocerciasis.2 We report the first case of scabies that reveals flame figures.

Report of a Case.  —A 29-year-old white woman presented to a dermatologist in private practice complaining of a 3-week history of multiple scattered, hemorrhagic, pruritic pustular skin lesions involving her arms and legs. On physical

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