Paeds SAQs · paediatric-dermatology
Scabies, lice and infestations — short-answer questions
Two short-answer questions on the clinical recognition, pathophysiology and household-based management of scabies and head lice in children, including crusted scabies and treatment resistance.
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Target exams
RACP DWEMRCPCH Theory
Prompt
A 4-year-old girl is brought to the clinic with a four-week history of an itch that is worst at night and after a hot bath. Examination reveals serpiginous burrows in her finger-webs and wrists, excoriated papules over her waist and genitalia, and honey-coloured crusting on several excoriated lesions. Her mother, father and baby brother all began scratching over the last fortnight. The family lives in a remote community with crowded housing.
Question 1 (10 marks)
Describe the clinical diagnosis, the underlying pathophysiology of the itch, and the stepwise management of this child and her family. In your answer address the 2020 International Alliance for the Control of Scabies diagnostic category that applies. [1]
References4ShowHide
- [1]Engelman D, Fuller LC, Steer AC The 2020 International Alliance for the Control of Scabies Consensus Criteria for the Diagnosis of Scabies. Br J Dermatol, 2020.PMID 32034956
- [3]Currie BJ, McCarthy JS Permethrin and ivermectin for scabies. N Engl J Med, 2010.PMID 20181973
- [6]Aung PTZ, Cuningham W, Hwang K Scabies and risk of skin sores in remote Australian Aboriginal communities: A self-controlled case series study. PLoS Negl Trop Dis, 2018.PMID 30044780
- [4]Dhana A, Yen H, Okhovat JP, et al. Ivermectin versus permethrin in the treatment of scabies: A systematic review and meta-analysis of randomized controlled trials. J Am Acad Dermatol, 2018.PMID 29241784