A very common disease in the past that still challenges dermatologists - Which is your diagnosis?

Alexandre Sabino Sisnando


A 6-year-old boy presented with a 5-year-history of allergic reactions to insect bite. Clinical examination revealed a child with marasmus and disseminated rash composed with papules. There was erythema and excoriation due to intense pruritus in recent lesions and lichenification with dyschromia in the oldest. Lesions predominated in extensor surface of limbs and face. He had painful lymphadenopathy in the axillary and inguinal region, and loss of weight. Histopathological examination revealed interruption of the epidermis, replaced by fibrinopurulent exudate. The dermis showed perivascular inflammatory infiltrate consisting of eosinophils, lymphocytes and histiocytes, compatible with prurigo. He was treated with systemic antihistamines, moisturizers for recovery of skin barrier function, topical antibiotic for secondary infection of the lesions and clinical support. He evolved with improvement of generalized pruritus and was discharged with a recovery nutrition plan. This case presents the characteristic lesions and lies within the profile of socioeconomic conditions of Hebra's prurigo.



Hebra; prurigo


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Boediardja SA, Tjarta A, Comain S, Budimulja U, Roostini A, Hartati M. The immunohistopathological features of Hebra. Med J Indones 2001; 10(1):1-15.

DOI: http://dx.doi.org/10.29021/spdv.73.2.307


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