Langerhans cell hyperplasia in scabies: a mimic of Langerhans cell histiocytosis.
OBJECTIVE
In the absence of mites, the histologic diagnosis of human scabies can be difficult. Scabies can mimic a variety of inflammatory and lymphoproliferative disorders. It is under-recognized that scabies can also mimic Langerhans cell histiocytosis.


METHODS
Sixteen examples of scabies were reviewed histologically and immunohistochemically (CD1a, CD3, CD20, CD30 and S100).


RESULTS
Immunohistochemical labeling showed florid CD1a and S100 positivity in most cases, indicative of Langerhans cell hyperplasia. Scattered CD30+ lymphocytes were also typically present, within a dense infiltrate, primarily composed of T lymphocytes and eosinophils.


CONCLUSIONS
Because of the prominent CD1a+/S100+ component, scabies can mimic Langerhans cell histiocytosis. This finding should be considered in conjunction with scattered CD30+ cells and clinical features to avoid misdiagnosis.
Bhattacharjee
Pradip
P
Department of Pathology, Yale University School of Medicine, New Haven, CT 06520-8059, USA.
Glusac
Earl J
EJ
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018949:Antigens, CD1 / Q000378:metabolism; D015415:Biomarkers / Q000378:metabolism; D003937:Diagnosis, Differential; D004804:Eosinophils / Q000378:metabolism / Q000473:pathology; D005260:Female; D006646:Histiocytosis, Langerhans-Cell / Q000175:diagnosis* / Q000378:metabolism; D006801:Humans; D006965:Hyperplasia / Q000378:metabolism / Q000473:pathology; D007223:Infant; D017730:Ki-1 Antigen / Q000378:metabolism; D007801:Langerhans Cells / Q000378:metabolism / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009418:S100 Proteins / Q000378:metabolism; D012532:Scabies / Q000175:diagnosis* / Q000378:metabolism; D013601:T-Lymphocytes / Q000378:metabolism / Q000473:pathology
D018949:Antigens, CD1; D015415:Biomarkers; C419393:CD1a antigen; D017730:Ki-1 Antigen; D009418:S100 Proteins