Scabies

This is a parasitosis caused by Sarcoptes scabiei var. hominis which can also affect children and babies. Contagion is mostly indirect, via bedding. The incubation period is around 3 weeks. The characteristics of scabies are intense pruritus, prevalently nocturnal, and clinically the cuniculum and the pathognomonic lesion. The predominant locations are the hands, flexor surface of the wrists, elbows, anterior portions of the armpits, breast areola, male genitals, buttocks and the sides of the feet. However, in children and babies, unlike adults, the whole skin surface may be affected, including the face and palmar-plantar surfaces.

Signs and symptoms

In addition to the cunicula, there are vesicles and pustules on the palms and soles, lesions from scratching and eczematous lesions. In general, the preferred location is inversely proportional to the age of the child. Recently, in small children a nodular form has been reported, which from the start presents with erythematous nodules in which the mite is located. These nodules may be the only symptom of scabies (monomorphic nodular variety) or be associated with the typical lesions. The nodules of the initial phase of the infestation should be differentiated from those which appear late (post-scabies nodules), show an inflammatory reaction and do not contain the mite. Dermoscopy permits a rapid diagnosis.

Diagnosis

Dermoscopy, search for the mite by direct microscopic examination of the material obtained by scarification of a cuniculum.

Complications

Bacterial superinfection encouraged by scratching-induced lesions and eczematisation caused by the irritant effect of anti-scabies topical agents are the most common complications.

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