Infant eczema or insect dermatitis? Dermoscopy solved the mystery

Xiao-Xi Xu , · Lu Zheng , · Yu-Ping Ran

A 4-month-old male infant presented with relapsing papules and pustules on his feet (especially on the sole of left foot) for one month (Fig. 1 a). He was in good health with no fever or obvious pruritus. Prior treatments of topical corticosteroid and antibiotics in a local hospital were ineffective. In our clinic,we went over those papules with dermoscopy one by one.A white tunnel with a small dark brown triangular structure(the head and the two pairs of front legs) and a transparent oval structure (the body of the mite) at its end, were observed on one of the papules (Fig. 1 b) [ 1, 2]. Scales of the tunnel were collected and examined by microscopy. Mites and eggs ofSarcoptes scabieiwere revealed. The diagnosis of scabies is confirmed (Fig. 1 c, d). Later he was treated with topical 5% sulfur ointment, and the lesions gradually disappeared in three weeks. Dermoscopy provides a rapid and noninvasive detection of atypical scabies infections in infants.

Fig. 1 The clinical and microscopic image of the infant. Papules were mainly distributed in the left foot for one month ( a); white tunnel with a mite (red circle, brown arrows referred to its head and white arrows referred to its body) were revealed by dermoscopy ( b); mites( c) and eggs ( d) were found under microscopy

Acknowledgements We thank the patient’s parents for granting permission to publish this information.

Author contributions XX: Software, writing-original draft preparation;LZ: Grammar checking, data collection; YR: Clinical and dermoscopy operation guidance, reviewing and editing.

Fundings The 1.3.5 project for disciplines of excellence (ZYJC18033),and, HX-Academician project (HXYS19003) of West China Hospital,Sichuan University.

Data availability Our article did not generate any research data.

Compliance with ethical standards

Ethical approval Written consent for publication of the case details together with imaging or videos have been obtained from the parents.

Conflict of interest No financial or non-financial benefits have been received or will be received from any party related directly or indirectly to the subject of this article.