14 yr indigenour male - lesion on anterior neck - been there | Figure 1

14 yr indigenous male - lesion on anterior neck - been there for 'months?' Mother says keeps 'tugging' on it.

Mild itchy - has had scabies Tx - No Hx of trauma or surgery - Not like a keloid. No scabies mites identified.

DDx?? please

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patient was started on scabies treatment topical. no change. she was given topical steroid for the lesions. says the scabies tx improved it but after 3 days of tx the lesions became pruritic again. my thinking is its either atopic dermatitis or a complicated case of scabies. Rare thing might be Reactive perforating collagenosis. thoughts on DDx?

Scabies mama and her scabie-babies in mineral oil prep

8 months old boy with scabies. #scabies

Dermoscopic image of #Scabies , tunnel sign

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