Clinical manifestation

Intense pruritus, particularly at night; slightly elevated, pink-white, linear, curved, or s-shaped line (burrow), located in webbed spaces of fingers, flexor surfaces of wrists, elbows, axillae, belt line, feet, and scrotum in men and areolae in women; burrows on the palms and soles in infants; vesicles; red papules on penile shaft Nodular variant: pink, tan, brown, or red nodules lasting for weeks Crusted (Norwegian) variant: occurs in immunocompromised and institutionalized patients; minimally pruritic, hyperk-

eratotic, crusted plaques over large areas; nail dystrophy; scalp lesions

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