Atypical Palmoplantar Scabies in an Adolescent: A Case Report.

Abstract

Background: Scabies is a common ectoparasitic infestation with characteristic age-related clinical patterns. Palmoplantar involvement is typically associated with infantile scabies and is rarely observed in adolescents, leading to diagnostic delay and mismanagement.

Case presentation: A 13-year-old male presented with a two-week history of intensely pruritic papular eruptions involving the trunk and acral areas, including the palms and soles. Pruritus was worse at night. Previous treatment with topical corticosteroids showed no improvement. Dermatological examination revealed diffuse erythematous papules on the trunk and symmetrical papulovesicular lesions with crusting on the palmoplantar surfaces. Based on clinical features and treatment failure, a diagnosis of scabies was made. The patient was treated with 6% sulfur ointment for three consecutive days, resulting in complete resolution of pruritus and clinical improvement within one week.

Conclusion: Palmoplantar lesions in adolescents, though atypical, should not exclude scabies. Early recognition, appropriate treatment, and household management are essential. Further studies are needed to characterize age-atypical presentations and optimize diagnostic strategies.