[Scabies triggering Darier's disease].
An increased incidence of scabies has been noted in many countries. Difficulties may arise when unrecognized infestations trigger or aggravate other dermatological disorders. We present an instructive case of Darier's disease, which did not respond to appropriate therapy regimens due to constant triggering by an undetected underlying scabies infestation. In this case, a 44-year-old Italian man presented with typical symptoms of Darier's disease. In addition, the patient reported massive pruritus, which is rather uncommon in this disorder. The disease proved recalcitrant to established treatment regimens resulting in excessive treatment costs. We confirmed the diagnosis of Darier's disease by histopathological analysis, and, in addition, detected arthropod fragments in the upper epidermis. Systemic ivermectin and topical allethrin followed by acitretin and PUVA-bath therapy resulted in rapid improvement of the debilitating pruritus as well as alleviation of the symptoms of Darier's disease.
Drewniok
Claudia
C
Klinik für Dermatologie und Venerologie, Otto-von-Guericke-Universität, Magdeburg. ClaudiaDrewniok@web.de
Schön
Michael P
MP
Krause
Markus
M
Gollnick
Harald
H
D000287:Administration, Topical; D000328:Adult; D000487:Allethrins / Q000008:administration & dosage / Q000627:therapeutic use; D007644:Darier Disease / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology* / Q000473:pathology; D006801:Humans; D007306:Insecticides / Q000008:administration & dosage / Q000627:therapeutic use; D007559:Ivermectin / Q000008:administration & dosage / Q000627:therapeutic use; D008297:Male; D011701:PUVA Therapy; D012532:Scabies / Q000150:complications* / Q000188:drug therapy; D012867:Skin / Q000473:pathology; D013997:Time Factors; D016896:Treatment Outcome
D000487:Allethrins; D007306:Insecticides; D007559:Ivermectin