A case of bullous scabies

We report a case of bullous scabies in an 81-year-old male patient. He had severe pruritic, multiple tense bullae on erythematous base with erosions and crusts from which scabies mites were identified, Histopathologic findings(H&E) revealed subepidermal bulla and direct immunofluorescence showed linear deposition of IgG and C3 at the dermoepidermal junction and linear IgG, C3 deposition at the dermal side of the salt split skin test. However, no EBA or BP antigens were detected. Although skin lesions improved after antiscabietic and oral steroid treatments, pruritic bulla developed repeatedly with scabies reinfestation or discontinuation of oral treatment.