Nodular Scabies of the Genitals

A 20 years-old-man, a native Indian of low socio-economic reckoning, had come to clinic with the complaints of severe nocturnal itching of the genitals for the past one month. A similar complaint was registered by other members of the household. The early diagnosis of the condition seemed to have been overlooked, because of conspicuous sparing of the usual sites namely the anterior axillary folds, elbows, wrists, webs of the fingers and around the umbilicus of the abdomen. Skin surface examination of the genitals, however, was remarkable, because it was studded by nodules of the size varying from 0.5 to 1cm. They were numerous (Figure 1a). Burrows were interspersed amongst them, and had miscellaneous configuration, harbouring Sarcoptes scabiei (Figure 1b). The imperative of its demonstration are emphasized to confirm the diagnosis.