MEDizzy - A 16-year-old camp counselor sees you to evaluate a severely

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Acute Complaints

A 16-year-old camp counselor sees you to evaluate a severely pruritic rash. You note pruritic erythematous papules in between his fingers, on his wrists, and around his waist. For which of the following is this distribution characteristic?

ExplanationThis case describes the classic distribution of scabies. Sarcoptes scabiei burrow into intertriginous areas, wrists, or areas where clothing is tight next to the skin. The lesions of chigger bites are similar, but bites are typically found in a linear pattern over wrists, ankles, and legs. Bedbugs typically infest unclothed areas—the neck, hands, and face. Fleas typically bite the lower extremities, and lesions from body lice would not follow the pattern described.