title: Superficial fibrin thrombi … and other findings: a review of the histopathology of human scabietic infections.
abstract: BACKGROUND
  Cutaneous infection with the mite Sarcoptes scabiei var. hominis is associated with epidermal and dermal changes. After noting superficial fibrin thrombi in two biopsies with scabies mites, we comprehensively reviewed the histopathologic findings in scabietic infections to determine the frequency of this finding.
  
  
  METHODS
  Twenty five biopsies of scabies infection were retrieved from the archives of our institution; only cases containing scabietic mite parts or scybala were included. The microscopic features were documented.
  
  
  RESULTS
  Nearly half (40%) of the cases showed fibrin thrombi within vessels of the superficial dermis. Other frequent findings included dermal eosinophils (88% of cases), epidermal spongiosis (76% of cases), lymphocyte atypia (64%), a superficial and deep infiltrate (52% of cases), dermal neutrophils (52%) and endothelial cell swelling (52%). Half of the cases contained polarizable mite elements. Less commonly encountered features included extravasated erythrocytes (44%), dermal edema (32%), pink 'pigtails'(28%), intraepidermal pustules (24%), plasma cells (20%) and vasculitis (4%).
  
  
  CONCLUSIONS
  The pathologic characteristics of scabietic infection are wide-ranging. Spongiosis, superficial and deep inflammation, and dermal eosinophils and neutrophils are seen in the majority of cases. Superficial fibrin thrombi are not uncommon in scabietic infection, and may provide a helpful diagnostic clue when mites are not visible on initial sections.
authors.affiliation: Department of Pathology, University of New Mexico School of Medicine, Albuquerque, NM, 87125, USA.|Department of Dermatology, University of New Mexico School of Medicine, Albuquerque, NM, 87125, USA.|Pathology Associates of Albuquerque, Albuquerque, NM, 87125, USA.
authors.forename: Hillary
authors.initials: H
authors.lastname: Elwood
authors.affiliation: Department of Pathology, University of New Mexico School of Medicine, Albuquerque, NM, 87125, USA.
authors.forename: Ryan S
authors.initials: RS
authors.lastname: Berry
authors.affiliation: Department of Pathology, University of Arkansas for Medical Sciences, Little Rock, AR, 72205, USA.|Department of Dermatology, University of Arkansas for Medical Sciences, Little Rock, AR, 72205, USA.
authors.forename: Jerad M
authors.initials: JM
authors.lastname: Gardner
authors.affiliation: Department of Pathology, University of Arkansas for Medical Sciences, Little Rock, AR, 72205, USA.|Department of Dermatology, University of Arkansas for Medical Sciences, Little Rock, AR, 72205, USA.
authors.forename: Sara C
authors.initials: SC
authors.lastname: Shalin
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D002648:Child; D002675:Child, Preschool; D004804:Eosinophils / Q000473:pathology; D005260:Female; D005337:Fibrin / Q000378:metabolism; D006801:Humans; D007223:Infant; D008214:Lymphocytes / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009504:Neutrophils / Q000473:pathology; D012520:Sarcoptes scabiei; D012532:Scabies / Q000097:blood* / Q000469:parasitology / Q000473:pathology*; D012867:Skin / Q000469:parasitology / Q000473:pathology; D013927:Thrombosis / Q000469:parasitology* / Q000473:pathology; D014657:Vasculitis / Q000469:parasitology / Q000473:pathology; D055815:Young Adult
chemical_list: D005337:Fibrin
keywords: fibrin thrombi; histopathology; infectious; scabies; scabietic