Not infrequently generic 75mg sinequan free shipping, patients with myiasis are misdiagnosed as having bacterial furun- culosis and are managed with a variety of antibiotics that have no effect cheap sinequan 25mg without prescription. It is important to consider the diagnosis of myiasis because occluding the punctum with fatty bacon causes the larvae to protrude buy sinequan 25mg fast delivery. Other occlusive sub- stances, such as petroleum jelly and nail polish, have also been effective. Excising the nod- ule for pathologic evaluation is not needed. A 37-year-old woman presents with intense perineal itching. On examination, she has both red papules and blue macules on the inner thighs. In addition, there are excoriated, crusted lesions in the same region. Tiny tan swellings are seen at the bases of some of the pubic hair shafts. Contact dermatitis Key Concept/Objective: To know the distinguishing characteristics of diseases that cause pruritic skin lesions This patient has pediculosis pubis, caused by Phthirus pubis. Its characteristic blue-gray macules (maculae ceruleae) are caused by the pubic lice sucking blood from the dermis. The tan swellings are nits: lice eggs cemented to the hair shaft. None of the other diseases 20 BOARD REVIEW listed have these findings. Scabies is caused by a burrowing mite that can at times be seen as a line in the stratum corneum. The mite’s eggs are deposited in the burrows rather than as nits. Dermatitis herpetiformis is an autoimmune vesicular dermatitis characterized by grouped vesicles symmetrically distributed over the extensor skin surfaces.