Skabies unter dem bild eines bullosen pemphigoids

A 75-year old male patient was hospitalized with the diagnosis of bullous pemphigoid because of widespread blisters. Histopathology revealed a subepidermal blister. By direct immunofluorescence (IF), linear deposits of IgG were found at the basement membrane zone. Circulating autoantibodies against the basement membrane zone could not be detected by indirect IF, immunoblot or ELISA. Microscopic analysis of skin scrapings revealed the presence of scabies mites. After treatment with a 0.5% hexachlorocyclohexane lotion (Jacutin Emulsion®) over three consecutive days and subsequent topical corticosteroid therapy, the lesions healed completely.