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Arch Dis Child Educ Pract Ed 92:ep65-ep69 doi:10.1136/adc.2005.073825
  • Best practice

Scabies in children

  1. Kaliaperumal Karthikeyan
  1. For correspondence:
    Dr K Karthikeyan
    Consultant Dermatologist and Venereologist, Sri Manakula Vinayagar Medical College, Kalitheerthalkuppam, Pondicherry, India; karthikderm{at}yahoo.co.in

    Scabies is a common dermatological problem managed by both paediatricians and dermatologists. It manifests itself in various forms in children and differs from that in adults in many ways. The treatment of scabies has developed with the evolution of new strategies and anti-ectoparasitic drugs. Drugs such as permethrin and ivermectin have revolutionised its treatment. The management of scabies not only includes prescribing the correct drugs but also educating patients about their application. Treatment failure can result from a variety of causes and must be managed appropriately.

    INTRODUCTION

    Human scabies is a worldwide disease, affecting all races and social classes in every climate from the coldest to the hottest regions.1 Scabies is prevalent in individuals of all ages but it is most common in the young, remains frequent in the older children and young adults, and thereafter sharply declines.2 Management of scabies in infants and children throws up unique challenges, as the manifestations are different in children. Furthermore, many drugs used in adults cannot be used in children because of their side effects and safety profile.

    DIAGNOSIS

    Scabies can be both one of the easiest and one of the most difficult conditions to diagnose.2 Scabies should be suspected in infants or children with generalised pruritus of recent onset and characteristic eruption. The site, severity, duration and timing of the itch are all useful in the diagnosis. Nocturnal itch is very characteristic of scabies. A history of itching in other members of the family should be sought and may give a clue to the diagnosis. The classical eruption of scabies presents as pruritic papules, vesicles, pustules and linear burrows. However most patients only have an admixture of the primary lesions along with excoriations, eczematisation, crusting and secondary infection. The path gnomonic scabies burrow is an elevated white and serpigenous tract measuring …