Page 42 - LECTURE NOTES
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the wrist, the elbows and the anterior axillary folds, the genitalia and inner thighs and
the gluteal folds
More disseminated presentation in infants and toddlers.
Scabies in infants and young children
9 Distribution and morphology:- generalized
9 The face the scalp, palms an soles are affected
9 Papules, vesicle and pustules
9 Secondary eczematization and impetiginazation are common
Crusted (Norwegian) scabies
In 1848, Danielssen and Boeck described a highly contagious variant of scabies
occurring in immunocompromised patients, elderly or mentally incompetent patients.
Thousands to million mites are found instead of the normal 8-11 mites in the normal
host. But 2-3% of HIV/ AIDS patients manifest Norwegian scabies.
In Norwegian scabies, pruritus may not be there (in about 50% of the cases do not itch)
It is psoriasiform and generalized with nail changes and scalp involvement
Skin becomes thickened and involves all part of skin including face, palms and sales.
DDX Acropustulosis of Infancy, Atopic Dermatitis, Contact Dermatitis ….
Diagnosis of scabies
o Itching, worse at night
o Presence of similar condition in the family or intimate contacts
o Characteristic distribution of lesions
o Demonstration of the mite, eggs or feces
o Therapeutic test
Management
o Treat with a scabicide agent
o All family members and close contacts should receive treatment at the same time
o Provide antihistamines to alleviate pruritus.
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