Treatment practices in the management of scabies in infants younger than two months

Abstract

Scabies is an ectoparasitic disease affecting more than 200 million people worldwide. 1 Although scabies affects all ages, children and infants carry a particularly high burden of disease. Prevalence in children is 5%-10% in some tropical resource-limited countries and as high as 34.1% in infants less than 1 year in the Solomon Islands. 1,2 Bacterial superinfection of scabies lesions can lead to systemic sequelae, including acute post-streptococcal glomerulonephritis and acute rheumatic fever. 1 Therefore, treatment is crucial. Worldwide, treatment options include oral ivermectin and topical agents such as permethrin, crotamiton, precipitated sulfur, lindane, benzyl benzoate, ivermectin, and malathion. Treatment availability and licensing vary by region. Despite scabies disproportionately affecting

The Efficacy, Safety and Tolerability of Sulfur in the Treatment of Scabies: A Cross-Sectional Study

“…10,12 Burning sensation, irritant contact dermatitis, and erythema are the other side effects. 7,9,10,14,16 Midfacial edema has also been reported. 14 Compatibly, 76% of our cohort had no side effects or suffered mild skin dryness, which was well tolerated.…”

Topical ivermectin: an off‐label alternative to treat neonatal Scabies in the era of permethrin resistance

“…It is caused by pathogenic variants in ENPP1 that encodes ectonucleotide pyrophosphatase/phosphodiesterase 1 (ENPP1); and both autosomal dominant (AD) and autosomal recessive (AR) modes of inheritance have been described. 3,5,6 Hypopigmented macules start from birth to 18 months. The ultrastructural studies of hypopigmented macules have shown the presence of disproportionately large numbers of melanosomes in the cytoplasm and dendrites of melanocytes but the reduced number of melanin content in the keratinocytes suggest an impaired melanosome transfer.…”

“…Editor, Cole disease (COLED, MIM #615522) is a rare genodermatosis characterized by dyspigmentation and punctate palmoplantar keratoderma (PPPK) of which only 13 families have been reported in the literature to date. [1][2][3][4][5][6][7][8] We report an Indian family with Cole disease with a novel pathogenic variant in ENPP1 in the somatomedin-B-like2 (SMB2) domain. A 4-year-old girl presented with slowly progressive hypopigmented lesions on upper and lower extremities (Fig.…”

“…5 Data on efficacy and safety of scabies treatments in paediatric patients are limited, even if topical permethrin is widely used although not approved for use in infants younger than 2 months of age in many parts of the world. 6 Alternative topical treatments include benzyl benzoate, sulphur or lindane that, however, holds the potential for skin irritation or systemic toxicity, especially in the youngest. Oral ivermectin is licensed for human scabies, but it is not approved in infant or child weighing <15 kg.…”

“…Ectopic calcifications are rarely encountered in both AD and AR variants of COLED. 3,5,6 Figure 2c shows all pathogenic variants reported to date for COLED. Our patients showed a novel variant in ENPP1 in the SMB2 domain with phenotypic variability among the two patients genetically tested.…”