title: Pink pigtail in a skin biopsy: What is your diagnosis?
abstract: Sarcoptes scabiei is an obligate ectoparasite, which burrows into the stratum granulosum of the epidermis and lays its eggs. The resultant host inflammatory response leads to intensely pruritic papules.
  A 63-year-old man undergoing treatment for immunoproliferative disease was suspected of having a pruritic drug eruption. Subsequent skin biopsy revealed an intracorneal burrow containing three pink, refractile pigtail-like structures, believed to be empty eggshells of S. scabiei.
  
  
  CONCLUSIONS
  Traditionally, the presence of adult mites or eggs in skin scrapings or a skin biopsy is required for a definitive diagnosis of scabies. However, our case and similar cases suggest that the diagnosis of scabies can also be made on the basis of pink pigtail-like structures, remnants of eggshells, within the intracorneal burrow.
authors.affiliation: Department of Pathology, Creighton University Medical Center, Omaha, Nebraska, USA.
authors.forename: Erica F
authors.initials: EF
authors.lastname: Reinig
authors.forename: Dan
authors.initials: D
authors.lastname: Albertson
authors.forename: Deba
authors.initials: D
authors.lastname: Sarma
mesh_terms: D001706:Biopsy; D003937:Diagnosis, Differential; D003875:Drug Eruptions / Q000175:diagnosis; D006801:Humans; D008297:Male; D008875:Middle Aged; D012532:Scabies / Q000175:diagnosis / Q000473:pathology*; D012867:Skin / Q000469:parasitology* / Q000473:pathology*