Question

A mother brings her 5 year old son to the doctor because he has been scratching an area on his chest for the past week. The itching is much worse at night. The patient has not had a known contact with poison ivy, has no history of a tick bite and his mother says that no one else has a rash like this. The child has been afebrile and has not been acting sick. There is a family history of eczema and so the patient's mother used some of her own steroid cream on her son's rash for the past three days, but this was not helpful. Physical exam reveals an area of small erythematous papules that are excoriated and tipped with blood crusts on his right upper chest extending under his right arm. There are several faint thin, brownish lines just under the surface of the skin. Several of the web spaces between his fingers also seem to have a similar appearing rash, as do the bottom of his feet. What is the most likely diagnosis in this patient?

A. Contact dermatitis
B. Atopic dermatitis
C. Scabies
D. Molluscum contagiosum
E. Skin atrophy and telangiectasias from the topical steroids

Answer 1

The most likely diagnosis in this patient is scabies, a contagious skin condition caused by a mite called Sarcoptes scabiei. It is characterized by intense itching, especially at night, and the presence of papules and burrows on the skin.

Step-by-step explanation:

The most likely diagnosis in this patient is scabies. Scabies is a contagious skin condition caused by a mite called Sarcoptes scabiei. It is characterized by intense itching, especially at night, and the presence of small erythematous papules that are excoriated and tipped with blood crusts. The faint thin, brownish lines just under the surface of the skin are called burrows, and they are a characteristic feature of scabies.