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Scabies in infants and children – a narrative review

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A Correction to this article was published on 20 April 2024

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Abstract

Scabies is a human ectoparasitosis caused by Sarcoptes scabei var. hominis. World-wide around 300 million patients are affected. Infants and children have the highest incidence rates. Poverty and overcrowding are social factors contributing to a higher risk of transmission and treatment failure. The leading symptom of the infestation is itch. Complications are bacterial infections that are responsible for mortality. Diagnosis is clinical. Non-invasive imaging technologies like dermoscopy can be used. Polymerase chain reaction (PCR) is less sensitive and specific than microscopy of skin scrapings. Treatment of choice is topical permethrin 5%. Ivermectin is the only oral drug FDA-approved for scabies. It should be used in cases non-responsive to topical therapy and in case of high number of infested patients in addition to topical therapy. Pseudo-resistance to treatment is not uncommon. New drugs are on the horizon.

What is Known:

• Pruritus is the leading symptom causing sleep disturbances and scratching with the risk of secondary bacterial infections.

• Treatment failure is related to inappropriate application of topical drugs and asymptomatic family members.

What is New:

• COVID-19 pandemic and migration are contributing to an increased incidence of scabies.

• New compounds to treat scabies are on the horizon.

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Data availability

As all data included in this review are already available via the cited references, a special statement on data availability is not applicable for this article.

Change history

Abbreviations

APSGN:

acute poststreptococcal glomerulonephritis

BB:

benzoyl benzoate

BW:

body weight

CCL:

chemokine ligand

COVID-19:

coronavirus disease 2019

FDA:

Food and Drug Administration

IACS:

International Alliance for the Control of Scabies

IgE:

immunoglobulin E

IFN-gamma:

interferon gamma

IgG:

immunoglobulin G

IL:

interleukin

JAK:

Janus kinase

OR:

Odd’s ratio

OTC:

over the counter

PCR:

polymerase chain reaction

S. scabiei:

Sarcoptes scabiei

SMSB4:

Sarcoptes mite serine protease inhibitor

STAT:

signal transducer and activator of transcription protein family

Th T:

helper cell

UV:

ultraviolet (light)

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Authors and Affiliations

  1. Department of Dermatology, Nicolina Medical Center, Iasi, Romania

    Anca Chiriac & Anca E. Chiriac

  2. Apollonia University, Iasi, Romania

    Anca Chiriac

  3. Romanian Academy, P. Poni Institute of Macromolecular Chemistry, Iasi, Romania

    Anca Chiriac

  4. Dermatology Ambulatory Care Center, “Grigore Alexandrescu” Clinical Emergency Hospital for Children, Bucharest, Romania

    Adriana Diaconeasa

  5. Pediatric Hospital, Ploiesti, Romania

    Raluca Miulescu

  6. Grigore T Popa University of Medicine and Pharmacy, Iasi, Romania

    Anca E. Chiriac

  7. Department of Dermatology and Allergology, Städtisches Klinikum Dresden, Academic Teaching Hospital of the Technical University of Dresden, Friedrichstrasse 41, 01067, Dresden, Germany

    Uwe Wollina

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Contributions

All authors whose names appear on the submission (A.C., A.D., R.M. A.E.C., U.W.) made substantial contributions to the conception or design of the work; the acquisition, analysis, and interpretation of data; A.C. and U.W. drafted the work, A.E.C. and D.A. and R.M. revised it critically for important intellectual content; A.C.,D.A., R.M., A.E.C. and U.W. approved the version to be published; and all agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

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Correspondence to Uwe Wollina.

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

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