It is a case study of a 62-yr-old female with crusted (Norwegian) scabies, which appeared during her treatment with systemic and topical corticosteroid therapy, under the diagnosis of erythroderma. In the same time, the patient had been suffered from hypothyoidism, and her skin changes were misdiagnosed, because it was thought that they are associated with her endocrine disorder. Suddenly, beside the erythema, her skin became hyperkeratotic, with widespread scaling over the trunk and limbs, and crusted lesions appeared on her scalp and ears. The microscopic examination of the skin scales with potassium hydroxide demonstrated numerous scabies mites and eggs. Repeated topical treatments with lindan, benzoyl benzoat and 10% precipitated sulphur ointment led to the complete resolution of her skin condition.
Administration, Topical ; Antiparasitic Agents/therapeutic use ; Dermatitis, Exfoliative/diagnosis/therapy ; Diagnostic Errors ; Female ; Glucocorticoids/*administration & dosage ; Humans ; Middle Aged ; Scabies/*diagnosis/drug therapy ; Skin/pathology

OBJECTIVETo investigate the clinical manifestations, complications and treatment of medicament-like dermatitis due to trichloroethylene (TCE), so as to provide basis for studying its etiology and mechanism.

METHODSFifty patients with dermatitis due to TCE from 1997 to 2000 were analysed retrospectively.

RESULTSThe occurrence of the dermatitis was not parallel to TCE exposure levels, without significant dose-effect relationship. This disease could be caused by both inhalation and skin exposure. The latency period of TCE dermatitis ranged from 5 to 66 days, and the average was 31.5 d (Medium). The major clinical manifestations included skin lesions, fever, superficial lymph node swelling and liver dysfunction. Infection was the major complication. Glucocorticoid was effective for treatment of this disease.

CONCLUSIONThe clinical manifestations due to TCE exposure were similar to dermatitis medicamentosa. The major clinical types of TCE dermatitis included exfoliative dermatitis and erythema multiforme. The dermatitis is considered to be mediated by delayed-type (IV) hypersensitivity. The key factors to treat this disease successfully included the use of glucocorticoid in time with sufficient dose and full course, professional skin care, active treatment to protect the liver and to avoid infection.

Adolescent ; Adult ; Allergens ; adverse effects ; Dermatitis, Exfoliative ; diagnosis ; etiology ; therapy ; Drug Eruptions ; diagnosis ; etiology ; therapy ; Female ; Humans ; Male ; Occupational Exposure ; adverse effects ; Retrospective Studies ; Trichloroethylene ; adverse effects