Scabies Infestation within the Horny Layer of a Facial Hyperkeratotic Nodule

Abstract

An 87-year-old male was referred to us for resection of a hyperkeratotic nodule on his cheek. The histological specimen revealed irritated hyperkeratotic seborrheic keratosis with an infestation of Sarcoptes scabiei hominis in its horny layer. This was the first sign of his scabies, which was already distributed over his fingers and groin. Keratotic skin lesions may serve as a reservoir for Sarcoptes scabiei hominis, making standard scabies treatment ineffective.