Introduction. The common cutaneous manifestations of human sarcoptic acaria
sis are erythematous and pruriginous papules. Vascular purpura in patients
with scabies has rarely been reported. We report a case of vascular purpura
in the presence of a transient elevation of anticardiolipin antibodies.
Case report. A 79 year-old woman was treated with prednisone and chlorambuc
il for a lymphoma. She was referred to our institution for diffuse sarcopti
c acariasis. Clinical examination showed a petechial purpura on her legs. H
istology of two biopsies of purpuric papules showed non inflammatory thromb
osis of the upper dermis vessels. Investigations revealed a transient eleva
tion of anticardiolipin antibodies, moderate hyperhomocysteinaemia and bloo
d eosinophilia. Treatment consisted in ivermectin and repeated applications
of benzyl benzoate lotion. The purpura healed within one month, without sp
ecific treatment.
Discussion. Histological findings of sarcoptic acariasis with vascular purp
ura correspond to leukocytoclasic vasculitis. Focal glomerulonephritis has
been reported. in our case, histopathology showed a non inflammatory thromb
osis of the dermal vessels. We hypothesize that the anticardiolipin antibod
ies, hyperhomocysteinaemia and blood eosinophilia may have been the cause o
f vascular thrombosis.