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Crusted scabies mimicking psoriasis in a patient with type 1 diabetes mellitus
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0 ] "pt" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Carta ‐ Caso clínico</span>" "titulo" => "Escabiose crostosa simulando psoríase em paciente com diabetes mellitus tipo 1" "tienePdf" => "pt" "tieneTextoCompleto" => "pt" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "385" "paginaFinal" => "386" ] ] "contieneTextoCompleto" => array:1 [ "pt" => true ] "contienePdf" => array:1 [ "pt" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0015" "etiqueta" => "Figura 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 737 "Ancho" => 1505 "Tamanyo" => 134797 ] ] "descripcion" => array:1 [ "pt" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Na avaliação após quatro semanas, as lesões cutâneas quase desapareceram.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ 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] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Beefy red asymptomatic penile lesion: unusual presentation of squamous cell carcinoma. Atypical cells with nuclear overcrowding, loss of polarity, lack of surface maturation, high N:C ratio, hyperchromatic nuclei, and multiple mitotic figures. Focal clear cell change is noted at the junction of atypical epithelium and normal epithelium (Hematoxylin & eosin, ×40).</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Seema Rani, Kabir Sardana, Arvind Ahuja" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Seema" "apellidos" => "Rani" ] 1 => array:2 [ "nombre" => "Kabir" "apellidos" => "Sardana" ] 2 => array:2 [ "nombre" => "Arvind" "apellidos" => "Ahuja" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "pt" => array:9 [ "pii" => "S2666275221000667" "doi" => "10.1016/j.abdp.2020.06.020" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "pt" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2666275221000667?idApp=UINPBA00008Z" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0365059621000647?idApp=UINPBA00008Z" "url" => "/03650596/0000009600000003/v2_202106040718/S0365059621000647/v2_202106040718/en/main.assets" ] "en" => array:17 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Case Letter</span>" "titulo" => "Crusted scabies mimicking psoriasis in a patient with type 1 diabetes mellitus" "tieneTextoCompleto" => true "saludo" => "Dear Editor," "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "385" "paginaFinal" => "386" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Yuanyuan Wang, Yeqiang Liu, Fu-Quan Long" "autores" => array:3 [ 0 => array:3 [ "nombre" => "Yuanyuan" "apellidos" => "Wang" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 1 => array:3 [ "nombre" => "Yeqiang" "apellidos" => "Liu" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:4 [ "nombre" => "Fu-Quan" "apellidos" => "Long" "email" => array:1 [ 0 => "md_longfuquan@163.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Department of Sexually Transmitted Disease, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Department of Pathology, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 560 "Ancho" => 750 "Tamanyo" => 66693 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0010" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Skin biopsy from glans showed hyperkeratosis, acanthosis of stratum malpighii. Stratum corneum revealed multiple subcorneal burrows containing <span class="elsevierStyleItalic">Sarcoptes scabiei</span> larvae and eggs. Dermis had inflammatory cell infiltration rich in eosinophils and lymphocytes (Hematoxylin & eosin stain, original magnification, ×20).</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Crusted or Norwegian scabies is an uncommon but highly contagious form of scabies, which is caused by the mite <span class="elsevierStyleItalic">Sarcoptes scabiei</span> var. <span class="elsevierStyleItalic">homini</span>, and mainly occurs in immunocompromised populations or people with poor sanitary conditions.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> Diagnosis can still be challenging, since the crusted lesions can imitate many kinds of skin conditions, such as psoriasis. We herein report a case of a diabetic patient with crusted scabies mimicking psoriasis vulgaris which had been misdiagnosed for 2-years.</p><p id="par0010" class="elsevierStylePara elsevierViewall">A 62-year-old man who complained of scaled plaques on the glans and buttocks for 2-years was referred to our clinic. Two years ago, the patient noticed some red papules on his glans and buttocks with an itching sensation, and the lesions gradually fused as plaques with white scales. He had been multiply diagnosed with psoriasis vulgaris and prescribed topical steroid treatment such as triamcinolone for a long time without significant improvement. The patient has a medical history of type 1 diabetes mellitus for more than 15-years but has never been well controlled.</p><p id="par0015" class="elsevierStylePara elsevierViewall">Physical examination revealed erythematous plaques covered with thick white scales on the glans and gluteal region (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>), and small amount of scattered erythematous papules around the trunk and genitalia. Blood work-up showed a significantly elevated level of fasting blood glucose at 18.4 mmoL/L. The serological test of <span class="elsevierStyleItalic">Treponema pallidum</span> particle agglutination and HIV were both negative. A biopsy from his glans lesions revealed numerous mites and eggs transects in the stratum corneum (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>). A diagnosis of crusted scabies was confirmed. After treatment with crotamiton 10% cream once a week for two weeks, the lesions started to diminish. At his fourth week's follow-up, the skin lesions disappeared (<a class="elsevierStyleCrossRef" href="#fig0015">Fig. 3</a>).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0020" class="elsevierStylePara elsevierViewall">Previous studies have shown that several pre-existing conditions may predispose these crusted scabies, such as AIDS, T-cell lymphoma, Down syndrome and immunosuppression in transplant recipients.<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1,2</span></a> In such conditions, the host’s immune system is overwhelmed and inadequate to defend against the parasitic mites, resulting in its subsequent, unrestrained growth. Diabetes mellitus was also one common comorbidity in patients with scabies. Some studies had revealed that elderly diabetics exhibited marginally higher risks of scabies, especially in the patients with type 1 diabetes mellitus.<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">Crusted scabies is characterized by massive colonization of mites in the epidermis, which lead to keratinocytic hyperplasia, crusted or superimposed eruptions. Psoriasis is one of the important differential diagnosis. Interestingly, it was reported that patients with scabies have a higher risk of subsequent psoriasis.<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> It is hard to interpret this association, but the common immunopathology involving the T-helper 17 cell-mediated inflammatory pathway may contribute to it.<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> Based on this fact, physicians may consider implementing assessments of psoriatic symptoms in patients with scabies.</p><p id="par0030" class="elsevierStylePara elsevierViewall">Inappropriate treatment can lead to the worsening of lesions. Using topical corticosteroids can decrease pro-inflammatory cytokines and phagocyte activity, which can thus alter the natural course of scabies, which lead to reduced immune responses and an itching sensation and then promote a crusted scabies appearance.<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> In our patient, the duration of misdiagnosis lasted for 2-years, mainly due to the immunosuppressive effects of repeated topical corticosteroids in addition to diabetes mellitus.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Financial support</span><p id="par0035" class="elsevierStylePara elsevierViewall">None declared.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Authors’ contributions</span><p id="par0040" class="elsevierStylePara elsevierViewall">Yuanyuan Wang: Approval of the final version of the manuscript; elaboration and writing of the manuscript; effective participation in research orientation; critical review of the literature.</p><p id="par0045" class="elsevierStylePara elsevierViewall">Yeqiang Liu: Approval of the final version of the manuscript; effective participation in research orientation; intellectual participation in pathology research of the case; critical review of the manuscript.</p><p id="par0050" class="elsevierStylePara elsevierViewall">Fu-Quan Long: Fu-Quan Long: Approval of the final version of the manuscript; conception and planning of the study; critical review of the literature and manuscript; elaboration and writing of the manuscript, and in charge of the whole manuscript.</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Conflicts of interest</span><p id="par0055" class="elsevierStylePara elsevierViewall">None declared.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:4 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Financial support" ] 1 => array:2 [ "identificador" => "sec0010" "titulo" => "Authors’ contributions" ] 2 => array:2 [ "identificador" => "sec0015" "titulo" => "Conflicts of interest" ] 3 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2020-04-28" "fechaAceptado" => "2020-06-02" "NotaPie" => array:2 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">How to cite this article: Wang Y, Liu Y, Long FQ. Crusted scabies mimicking psoriasis in a patient with type 1 diabetes mellitus. An Bras Dermatol. 2021;96:385–6.</p>" ] 1 => array:2 [ "etiqueta" => "☆☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0010">Study conducted at the Shanghai Skin Disease Hospital, Shanghai, China.</p>" ] ] "multimedia" => array:3 [ 0 => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 689 "Ancho" => 1500 "Tamanyo" => 135561 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Erythematous plaques covered with thick white scales on the glans and gluteal region.</p>" ] ] 1 => array:8 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 560 "Ancho" => 750 "Tamanyo" => 66693 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0010" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Skin biopsy from glans showed hyperkeratosis, acanthosis of stratum malpighii. Stratum corneum revealed multiple subcorneal burrows containing <span class="elsevierStyleItalic">Sarcoptes scabiei</span> larvae and eggs. Dermis had inflammatory cell infiltration rich in eosinophils and lymphocytes (Hematoxylin & eosin stain, original magnification, ×20).</p>" ] ] 2 => array:8 [ "identificador" => "fig0015" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 789 "Ancho" => 1500 "Tamanyo" => 110411 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0015" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">At the fourth week’s follow-up, the skin lesions almost disappeared.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:5 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Ectoparasites: Scabies" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "C. 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| Ano/Mês | Html | Total | |
|---|---|---|---|
| 2024 Novembro | 15 | 7 | 22 |
| 2024 Outubro | 104 | 66 | 170 |
| 2024 Setembro | 137 | 95 | 232 |
| 2024 Agosto | 155 | 131 | 286 |
| 2024 Julho | 136 | 99 | 235 |
| 2024 Junho | 113 | 60 | 173 |
| 2024 Maio | 80 | 60 | 140 |
| 2024 Abril | 95 | 75 | 170 |
| 2024 Março | 74 | 69 | 143 |
| 2024 Fevereiro | 104 | 82 | 186 |
| 2024 Janeiro | 65 | 49 | 114 |
| 2023 Dezembro | 56 | 83 | 139 |
| 2023 Novembro | 78 | 67 | 145 |
| 2023 Outubro | 55 | 75 | 130 |
| 2023 Setembro | 85 | 73 | 158 |
| 2023 Agosto | 72 | 31 | 103 |
| 2023 Julho | 70 | 30 | 100 |
| 2023 Junho | 80 | 47 | 127 |
| 2023 Maio | 57 | 17 | 74 |
| 2023 Abril | 45 | 19 | 64 |
| 2023 Março | 77 | 50 | 127 |
| 2023 Fevereiro | 62 | 39 | 101 |
| 2023 Janeiro | 51 | 40 | 91 |
| 2022 Dezembro | 50 | 29 | 79 |
| 2022 Novembro | 82 | 50 | 132 |
| 2022 Outubro | 101 | 53 | 154 |
| 2022 Setembro | 51 | 69 | 120 |
| 2022 Agosto | 50 | 53 | 103 |
| 2022 Julho | 46 | 70 | 116 |
| 2022 Junho | 55 | 60 | 115 |
| 2022 Maio | 36 | 51 | 87 |
| 2022 Abril | 61 | 54 | 115 |
| 2022 Março | 64 | 76 | 140 |
| 2022 Fevereiro | 34 | 49 | 83 |
| 2022 Janeiro | 61 | 80 | 141 |
| 2021 Dezembro | 42 | 62 | 104 |
| 2021 Novembro | 54 | 66 | 120 |
| 2021 Outubro | 59 | 88 | 147 |
| 2021 Setembro | 49 | 64 | 113 |
| 2021 Agosto | 52 | 60 | 112 |
| 2021 Julho | 88 | 62 | 150 |
| 2021 Junho | 108 | 92 | 200 |
| 2021 Maio | 73 | 78 | 151 |
| 2021 Abril | 173 | 246 | 419 |
| 2021 Março | 28 | 28 | 56 |
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