Two Cases of Scabies Located Exclusively on a Toenail: A Case Report

Area of Science:

• Dermatology
• Parasitology
• Clinical Medicine

Background:

• Nail involvement is a known complication of crusted scabies, typically presenting as subungual hyperkeratosis and onycholysis.
• Classical scabies (Sarcoptes scabiei infestation) rarely involves the nails, making such cases infrequently reported in medical literature.

Observation:

• This report details two unique cases of classical scabies presenting exclusively on a single toenail.
• The first patient exhibited complete nail plate disappearance, while the second presented with a thickened, greyish-brown nail plate and surrounding scales.

Findings:

• The study successfully treated both patients with a combination of topical permethrin and oral ivermectin.
• These findings demonstrate the efficacy of standard scabies treatments even in atypical, localized presentations.

Implications:

• The cases suggest that classical scabies can present with unusual nail-exclusive manifestations.
• Understanding these atypical presentations is crucial for accurate diagnosis and timely treatment of scabies.
• Further research may explore the specific factors contributing to localized, nail-predominant scabies infections.