Unusual Bullous Manifestation of Scabies in Childhood Diagnosed by Dermoscopy: A Case Report

Scabies is a common ectoparasitic infestation, but atypical variants such as bullous scabies are rare and often misdiagnosed. We report a 12-year-old boy who presented with pruritic lesions comprising predominantly vesicles and bullae over the hands, along with a few scattered excoriated papules on the trunk and thighs. Dermoscopic evaluation revealed the characteristic "jet with contrail" sign in the interdigital area, confirming the diagnosis of scabies according to the 2020 International Alliance for the Control of Scabies criteria. The patient was treated with two applications of topical 5% permethrin 1 week apart, along with symptomatic therapy, resulting in complete resolution without sequelae at 4 weeks. This case highlights bullous scabies as an underrecognized pediatric presentation and underscores the value of dermoscopy as a rapid, noninvasive diagnostic tool that can prevent misdiagnosis, avoid unnecessary investigations, and ensure timely, effective treatment.