A review of Scabies in infants and children

Scabies, an ectoparasitic infection caused by the mite Sarcoptes scabei var. hominis, affects approximately 300 million people globally, with the highest incidence found in infants and children. COVID-19 pandemic and migration are factors leading to a rise in scabies cases. Social factors such as poverty and overcrowded living conditions significantly increase the risk of transmission and complicate treatment efforts. The primary symptom of scabies is intense itching, which can lead to secondary bacterial infections, posing serious health risks and contributing to mortality.

Diagnosis is primarily clinical, although non-invasive techniques like dermoscopy can assist. Polymerase chain reaction (PCR) is available but is less sensitive and specific compared to traditional microscopy of skin scrapings. The preferred treatment is topical permethrin 5%, while ivermectin, the only oral medication approved by the FDA for scabies, is recommended for cases that do not respond to topical treatments or when there are large outbreaks. However, instances of pseudo-resistance to treatment can occur. Research into new therapeutic options is underway, promising potential advancements in the management of scabies.

Source: Chiriac A, Diaconeasa A, Miulescu R, et al. Scabies in infants and children – a narrative review. Eur J Pediatr.2024;183:2527–2536. https://doi.org/10.1007/s00431-024-05535-1

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