Scabies in Childhood
Sidney Hurwitz MD1
1 Associate Clinical Professor, Pediatrics and Dermatology, Yale University School of Medicine, New Haven, Connecticut
Scabies is an extremely contagious disorder caused by an itch mite, Sarcoptes scabiei, which attacks infants and children as well as adults. Infestation begins with a newly fertilized female mite. She tunnels into the stratum corneum and lives in cutaneous burrows which may measure several millimeters to a few centimeters in length. The parasite favors areas with a low concentration of pilosebaceous follicles and a thin stratum corneum. This seems to account for a difference in the distribution of lesions in infants and young children compared to older children and adults.1
INCIDENCE
Epidemics of scabies occur in 30-year cycles, each one lasting about 15 years. We presently are near the end of a world-wide pandemic which began in 1964 and, if estimates are correct, should last until or beyond 1979 or 1980.2
CASE HISTOR
A 3-month-old white female infant started with a pruritic eruption at 2 months of age. She had a scaly erythematous papular eruption on the trunk, the postauricular areas, and extremities (Fig 1) and was otherwise healthy.3 Microscopic examinations of skin scrapings and fungal cultures were performed, and the eruption was treated as a seborrheic dermatitis with frequent shampoos and topical fluocinolone acetonide cream.
Two weeks later the rash had spread to the back of the head and neck, the entire trunk, and all extremities including the palms and soles.
