Atypical Mycobacterium Arising in the Setting of Postscabetic Pruritus

Document Type

Conference Proceeding

Publication Date

8-2025

Publication Title

Journal of Investigative Dermatology

Abstract

Atypical mycobacterium infections appear to be increasing in incidence with one study demonstrating a threefold increase in incidence from 1980 to 2009. Atypical mycobacterial infections have been shown to be associated with trauma and conditions that disrupt the skin barrier such as prurigo nodularis. Postscabetic pruritus is a common occurrence after scabies treatment and may last weeks to months. This case study highlights the unusual presentation of atypical mycobacterium in a patient with postscabetic pruritus after treatment for scabies. A 54-year-old male, with a history of scabies presented with multiple erythematous papules and erosions bilaterally on his upper and lower extremities. His prior treatment for scabies included 2 courses of ivermectin and 3 courses of permethrin over the span of a year by primary care. At the time of presentation to dermatology, the patient was being treated with oral clindamycin and oral metronidazole due to persistent pruritus. Diagnostic work-up included lower extremity skin biopsies and a PCR assay. The patient was started on oral doxycycline and topical mupirocin 2% ointment mixed with Medihoney twice daily to skin ulcers. While the biopsies did not reveal mycobacteria, the PCR assay identified the presence of Mycobacterium chelonae and Mycobacterium fortuitum. Infectious disease consultation confirmed that doxycycline was effectively managing the atypical mycobacterial infection. This case underscores the importance of considering atypical mycobacterial infections in patients with postscabetic pruritus.

Volume

145

Issue

8 Suppl

First Page

S112

Last Page

S112

Comments

Annual Meeting of the Society for Investigative Dermatolgy, May 7-10, 2025, San Diego, CA

DOI

10.1016/j.jid.2025.06.656

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