More bug bites | Figure 1

Some actions are only available when you log in.

You can view up to 4 cases without signing up.

Why you should join Figure 1

Similar cases



33 to male with multiple discrete papules on BL LE. Began after returning from Ireland. Treated with topical steroids, oral steroid x 21 days and permetherin without resolution. Non-pruritic, no contacts with similar sxs. Ddx?](https://app.figure1.com/case-detail/038abbde-2ea1-486f-a7f3-1eac5f715e00)



Small, raised, blanchable "bumps" presenting on a 2 year old brother and 8 month old sister. Scattered over torso, hands, feet, neck. Some appear to have pus in center. Some soft to touch, others hard. No c/o pain or itching. Low grade fever precedes these spots. Hx of about 1 month. Any guesses?](https://app.figure1.com/case-detail/273ce2dd-6d89-492c-80fb-7b0171936e76)



Authors: Dr. Shamas Rafique MD, Dr. Iqra Rafiq MD, Dr. Numra Rafiq BDS
Abstract:
This case report details the presentation and successful treatment of scabies in a 58-year-old female patient who suffered from severe pruritus, accompanied by bilateral upper and lower limb rashes, for two months. Initially misdiagnosed with dermatitis, the patient’s condition improved significantly after treatment with permethrin topical cream and Zyrtec.
Case Presentation:
A 58-year-old female presented with a two-month history of intense itching and bilateral rashes on the upper and lower limbs, predominantly affecting the interdigital spaces, wrists, and axillae. Initial examination suggested a dermatitic process, and she was prescribed topical corticosteroids. However, her symptoms persisted, prompting a reevaluation.
Clinical Findings:
On reexamination, the patient exhibited erythematous papules, burrows, and excoriations, predominantly affecting the wrists, interdigital spaces, and axillae. Additionally, bilateral rashes were observed on the upper and lower limbs. A skin scraping revealed Sarcoptes scabiei mites and their ova, confirming the diagnosis of scabies.
Treatment and Outcome:
The patient was treated with permethrin 5% topical cream applied from neck to toes for eight hours, followed by a thorough rinse. Additionally, Zyrtec was prescribed for pruritus control. After one week, the pruritus significantly diminished, and a follow-up examination revealed a marked reduction in the number of lesions and mite counts.
Discussion:
This case emphasizes the importance of clinical suspicion for scabies in patients presenting with intense pruritus and characteristic rashes, even if initial diagnoses suggest dermatitis. Early recognition and appropriate treatment can lead to prompt resolution of symptoms and prevention of further transmission.
Conclusion:
In cases of persistent pruritus accompanied by bilateral rashes on the upper and lower limbs, a high index of suspicion for scabies should be maintained. Timely diagnosis and treatment with permethrin topical cream, in conjunction with antipruritic agents like Zyrtec, can lead to a successful resolution of symptoms and improved quality of life for affected patients.](https://app.figure1.com/case-detail/334f76c0-931f-47e2-b1f7-6f1df0ab3a9d)



Lice. First stage: Nits](https://app.figure1.com/case-detail/4064ff2f-d531-4af9-97e9-34b53b503da3)



A 52-year-old man presented with a 20-minute history of chest pain radiating to the left shoulder and neck, associated with dyspnea and diaphoresis.
He had a history of hypertension, long-term smoking, and a sedentary lifestyle.
On physical examination, bibasilar crackles were noted on lung auscultation. An electrocardiogram (ECG) was performed in the primary care setting, and the patient was promptly referred to the emergency department.](https://app.figure1.com/case-detail/ae0fe999-6875-4474-94f0-ad823dbb9b3a)



A 28-year-old woman presented with a 3-day history of intense pruritus over the lower back. She reported no recent travel or exposure to new environments. She cares for a small kennel with approximately eight dogs rescued from the streets.
Physical examination revealed multiple small vesicles, some clustered and others scattered, predominantly involving the lumbar region and the left gluteal area.](https://app.figure1.com/case-detail/c271070f-2bc7-4052-9895-635277e1a7d5)



A 4-month-old male infant presented with skin lesions localized to the chin for the past 3 days. Physical examination revealed multiple small pustules with surrounding inflammatory signs on the chin, along with a few scattered papules on the chest.](https://app.figure1.com/case-detail/48f41642-b9db-4089-b120-a94ee52328de)



patient in late teens presenting after a collapse, no chest pain, no previous cardiac history, no history of sudden death in family, are there any features in this ekg that would warrant further work-up or is this just a pediatric ekg?](https://app.figure1.com/case-detail/2af390e1-ace8-40ed-ba1c-98fb2d72f4c5)