Scabies associated with radiation therapy for cutaneous T-cell lymphoma

Scabies, infection with Sarcoptes scabiei, is known to be predisposed to by poor body hygiene, environmental exposure, and systemic immunodeficiency W e report the case of an 83-year-old man with Sezary's syndrome who develope d scabies limited to the skin of the upper chest, the same location where: he had previously received electron beam radiation treatments for cutaneous T-cell lymphoma. Histologic and immunohistochemical studies demonstrated t hat sections of the previously irradiated right and left chest skin, compar ed to lion-irradiated chest, abdominal, and leg skin, had infestation by sc abies, diminished involvement by T-cell lymphoma, and notably reduced numbe rs of Langerhans cells. These findings suggest that the development of scab ies may be predisposed to by local cutaneous radiation therapy, and that it may be mediated by local cutaneous immunodeficiency secondary to reduced n umbers of Langerhans cells.