Xumei Wu,1,2 Feifei Yang,3 Ruina Zhang1 

1Department of Dermatology, Beijing Friendship Hospital, Capital Medical University, Beijing, People’s Republic of China; 2Department of Dermatology, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, People’s Republic of China; 3Department of Dermatology, Tongzhou Maternal & Child Health Hospital of Beijing, Beijing, People’s Republic of China

Correspondence: Ruina Zhang, Department of Dermatology, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, People’s Republic of China, Tel +8613811708671, Email zrn1780@126.com

Objective: To outline the clinical manifestations observed in patients with scabies misdiagnosed as generalized eczema, analyse the factors contributing to these misdiagnoses and explore potential reasons for the resurgence of scabies.
Patients and Methods: A retrospective analysis was performed to investigate the patients with scabies misdiagnosed as generalized eczema.
Results: We included 23 patients, with twelve (52.17%) being male and eleven (47.83%) female. The illness duration ranged from 0.5 to 7 months. Among all patients, 12 (52.17%) were residents of nursing homes, 5 (21.74%) were staff members of these facilities, 4 (17.39%) were caregivers of long-term hospitalized relatives, 1 (4.35%) was a construction worker, and 1 (4.35%) had a history of tourism. The rash predominantly affected the trunk and extremities, 12 patients (52.17%) are each involved the perineum and fingers webbings. The presentations included erythema, papules, and nodules. The main complaint of all patients was nocturnal itch. Under direct microscopy, 5 patients (21.74%) tested positive for scabies mites, and 3 (13.04%) showed histopathological features consistent with scabies. All patients were initially misdiagnosed with generalized eczema.
Conclusion: Over half of all patients diagnosed with scabies either resided or worked in long-term care facilities. The lack of awareness of scabies among medical staff in long-term care facilities readily led to frequent misdiagnosis. Comprehensive measures should be implemented urgently to strengthen disease management.

Keywords: scabies, long-term care facilities, elderly, misdiagnose, pruritus