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Extensive body lice infestation - note the excoriations and hyperpigmentation. The dusty dots on the clothing seams are all adult lice (PL-patient1)
Keywords: Arm, Bilateral arms, Bilateral legs, Chronic human body lice, Ectoparasite, Excoriation marks, Generalised pruritus, Leg, Lice-infested underwear, Louse infestation, Male, Pediculosis corporis type, Pediculus humanus corporis, Post-inflammatory hyperpigmentation, Sucking lice, Vagabond disease
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Source: Dr Ian Coulson