2. Pediatric
Scabies
By:
Dr. Ashraf Hamza
Professor of
Dermatology & Venereology
Alexandria University

3. Scabies
Definition:
Infectious parasitic disease of the
skin caused by sarcoptes scabiei
Epidemiology:
•
•
•
•
•
Epidemic every 10 years
Seasonal variations
Incidence in war time
Age factor
Promoting factors

4. Biology of Scarcoptes
scabiei
•
•
•
•
•
•
Skin specific parasite
Morphology
Male and female sizes
Legs
Speed of parasite
Life cycle

5. Scabies
Mode of transmission:
Direct contact:
Direct contact with infected mother.
To diagnose infantile scabies the
mother should be scabetic.
Indirect contact:
Through bed sheets and clothes.
This plays a minor role in the
transmission of scabies in infants.

6. Scabies
Clinical Features:
Complaint:
•Itchy skin eruption. However, neonates
do not itch but present with irritation
•Causes of itching:
 Paratsite act as F.B. in the skin
Toxins released by mites
Burrowing action of female mites
Toxins released from dead mites

7. Scabies
Clinical Features:
Distribution of lesions:
• In Children
• In the first year of life
• In neonates

8. Scabies
Clinical Features:
Morphology of lesions:
Polymorphic skin eruption
Tunnel or Burrow:
Morphology of tunnel
Why usually not seen?

9. Scabies
Clinical Features:
Other lesions:
 Papules
 Nodules
 Vesicles
 Pustules & bullae
 Crusts
 Urticarial wheel
 Scratch marks

10. Scabies
Complications:
Secondary eczematization:
It is a frequent complication
Wide surface area is involved
Features of eczematization
Effect on child general
condition

11. Scabies
Complications:
Secondary infection:
Precipitating factors
Effect of pyoderma on mites
Clinical types of infections
Post Strept Glomerulonephritis:
Secondary to bacterial infection
Incidence

12. Scabies
Clinical Types:
Crusted (Norwegian)
Scabies:
Precipitating factors
Pruritus is minimal
Number of mites
Palms and soles
Infectivity

13. Scabies
Clinical Types:
Animal Scabies:
Mode of transmission
Biology of animal mite
Course of the disease
Distribution of lesions
Clinical features
Infectivity

14. Scabies
Clinical Types:
Scabies Incognito:
Definition
Clinical features
Infectivity
Prolonged systemic steroids

15. Scabies
Clinical Types:
Nodular Scabies:
Pathogenesis
Clinical features
Histopathology
Course

16. Scabies
Criteria for diagnosis:
Itchy skin eruption
Positive family history
Polymorphic skin eruption
Specific localizations
Hebra test
Probe test
Blood picture

17. Scabies
Differential Diagnosis:
From diseases characterized by
itchy polymorphic skin eruption
 Papular urticaria
 Dermatitis herpetiformis
 Chicken pox
 Mastocytosis

18. Treatment of Scabies
General Measures:
 The patient should avoid
contacts
 Treatment of contacts is
essential
Systemic should be disinfected
 Clothes Therapy:
 Antihistamines
 Antibiotics
 Ivermectin

19. Treatment of Scabies
Topical Antiscabetic Agents:





Sulphar 5%
Permethrin 5%
Gamma benzene hexachloride 1%
Benzyl benzoate 30%
Crotamiton

20. Treatment of Scabies
Rules in therapy:
 Bathing is preferred
 Sites of application
 Frequency of applications
 Irritant nature of drugs

21. Treatment of Scabies
Treatment of other clinical
types:
 Crusted scabies
 Nodular scabies
 Eczematized scabies

22. Thank You