Scabies: Or something else? Differential Diagnosis

Skin and subcutaneous (L00-L99).

  • Atopic eczema (neurodermatitis).
  • Bullous pemphigoid (BP) – blistering skin disease; occur especially in elderly patients.
  • Infantile atopic eczema (usually from the 3rd month of life) or atopic eczema (neurodermatitis) (manifestation possible at any age).
  • Infantile eosinophilic pustular folliculitis (DD scabies in early infancy).
  • Contact dermatitis (manifestation possible at any age).
  • Neonatal bullous impetigo (localized) (DD scabies in early infancy).
  • Nonbullous impetigo (impetigo contagiosa/boring lichen; suppurative impetigo) – highly infectious purulent infection of the skin (pyoderma) not attached to the skin appendages (hair follicles, sweat glands) caused by serogroup A streptococci (GAS, group A streptococci). (Infancy and childhood).
  • Pruriginous eczema – severely itchy skin lesions.
  • Pyoderma (pustular rash; burning, purulent inflammation of the skin).
  • Scabies bullosa: DD bullous pemphigoid (BP); appearance of blisters: Localization: mostly trunk and extremities, rarely neck and genital region, occasionally generalized (Occurrence: old age, males).
  • Scabies crustosa (synonyms: Scabies norvegica; bark scabies) – massive mite infestation with psoriasiform changes and palmoplantar hyperkeratoses; possibly also an erythroderma; pruritus may be completely absent (due to lack of immune response); risk groups: immunocompromised patients (HIV, malignancies; immunosuppressants), immunodeficiency in old age.
  • Papular/nodular scabies (reddish-brown papules/nodules) DD postscabial granulomas.
  • Scabies incognito (larval scabies) – in this form of scabies, the skin symptoms are absent.
  • Pseudoscabies – by Ubertragung of animal mites (= animal mite dermatitis), including poultry, dog, cat, cattle, pig; humans are false hosts (manifestation at any age possible).

Infectious and parasitic diseases (A00-B99).

  • Frambösia – non-venereal infectious disease of the tropical treponematosis group occurring in tropical regions.
  • Neonatal candidiasis/infectious diseases caused by fungi of the genus Candida (DD scabies in early infancy).
  • Neonatal herpes simplex infection (DD scabies in early infancy).
  • Trombidiosis (harvest scabies)

Neoplasms (C00-D48)

  • Histiocytosis/Langerhans-cell histiocytosis (abbreviation: LCH; formerly: histiocytosis X; Engl. histiocytosis X, langerhans-cell histiocytosis) – systemic disease with proliferation of Langerhans cells in various tissues (skeleton 80% of cases; skin 35%, pituitary gland 25%, lung and liver 15-20%); in rare cases, neurodegenerative signs may also occur; in 5-50 % of cases, diabetes insipidus (hormone deficiency-related disturbance in hydrogen metabolism leading to extremely high urine excretion) occurs when the pituitary gland is affected; seborrheic eczema-like lesions in the capillitial area (emphasized at the temples) and scaly crust-covered papules (nodules) in the trunk area; often hemorrhagic (children are more often affected than adults); the disease occurs disseminated (“distributed over the whole body or certain body regions”) frequently in children between 1-15 years of age, less frequently in adults, here predominantly with an isolated pulmonary affection (lung affection); prevalence (disease frequency) approx. 1-2 per 100,000 inhabitants

Symptoms and abnormal clinical and laboratory findings not elsewhere classified (R00-R99).

  • Dermatoses (skin diseases) associated with vesicle/blister and/or pustule formation: see ” Vesicles and Bulla” or “Papule” below.

Injuries, poisonings, and certain other sequelae of external causes (S00-T98).

  • Insect bite (usually caused by mosquitoes) (manifestation possible at any age).