A 91-year-old woman presented with a 3-month history of [extensive](javascript:;) cutaneous lesions with intense pruritus. She lived in a nursing home for a long time. Physical examination revealed a generalized erythematous and scaly rash with intense hyperkeratotic lesions on the neck, trunk, and limbs. Dermoscopy showed a sinuous burrow filled with white dot eggs and feces on the hand with a mite at the end of the burrow. Reflectance confocal microscopy (RCM) manifested a sinuous burrow and a mite. The presence of mites was confirmed with fluorescence staining. The patient was diagnosed with crusted scabies and started treatment with 10% sulfur ointment. Her lesions and pruritus were resolved after 2 weeks.
Keywords: dermoscopy; fluorescence staining; noninvasive diagnosis; reflectance confocal microscopy; scabies.
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