Are the symptoms of scabies in children the same as in adults? How is it treated?

Scabies (lat. scabies) is a highly contagious infectious skin disease.

Its causative agent is the ectoparasite Sarcoptes scabiei (lat. Sarcoptes scabiei).

It affects humans and other mammals. Animals, however, tend to be infested by different species of scabiei than humans, so animal-to-human transmission is not possible.

Scabies is caused by a parasite - the scabies mite

The scabies mite is a microscopic ectoparasite belonging to the mite family, which is also the causative agent of scabies.

The female grows to a size of 0.2 to 0.5 mm and is responsible for the disease.
The male is much smaller, measuring about 0.2 mm.

It has a flattened body and eight small, dwarf, cone-shaped legs.

Despite the presence of the legs, these parasites move very slowly, at a rate of about 2 to 2.5 cm per minute. Therefore, prolonged contact between a potential host and an infected individual is rarely enough to spread the infection.
Prolonged contact with an infected human is necessary for the slow-moving ghost to spread the infection.

How is scabies transmitted between people?

1. Transmission of the disease between people occurs mainly through direct skin contact after prolonged exposure.
2. Indirect transmission is less common. A person usually becomes infected through contaminated objects (mainly textiles - towel, bedding, clothing).

The risk of transmission of scabies is lack of hygiene, neglect.

Transmission most often occurs in collective facilities such as sanitary facilities, hostels, but also schools, kindergartens and other institutions.

Collective transmission results in smaller epidemics in a particular facility.

Why does scabies often occur in children?

Infection generally occurs frequently in children. Transmission of the disease occurs from an infected mother or other relative or while staying in a child care facility with an incidence of scabies.

Scabies in child care facilities spreads relatively quickly (bedding, towels, clothing).

Another reason is close contact of children during play.

Does your child have symptoms of scabies?

The symptoms of scabies in an adult and a child are the same.

• The disease begins with itching of the skin at night, which increases in intensity. Later, it appears during the day.
• Reddened areas and scratches appear on the skin.
• It is also possible to see longitudinal or axe-shaped passages in the subcutaneous tissue, which have been drilled by the activity of the mite.
• At the end of the blinded corridor, a dot-shaped crust can be observed.
• Rash to papulose formations also appear on the skin.
• Persistent scratching causes secondary skin lesions such as scratches, abrasions, localised bleeding of the skin and crusts.
• Itching also results in insomnia, irritability and nervousness.

The difference in the manifestation of scabies in children and adults is the localization of the skin lesions. In a child, they are also found in places where they are not seen in an adult.

Table with basic differences in the localization of skin lesions in scabies in children and adults:

Why is it more difficult to diagnose scabies in children?

Diagnosing scabies in children is much more difficult than in adults.
As can be seen in the table above, the localization of skin manifestations varies.
In children, lesions are found mostly on the face and do not omit the palms and soles. It is in these places that they are absent in adults.

In children, skin lesions affect mainly the facial part of the skin.
As is usual, other diseases are often observed on the face of young children, namely various eczema, allergies, atopy or rashes.
The probability that scabies may be a disease is minimal. Therefore, many times it is not thought of.

Another diagnostic problem in young children is the difficulty in identifying the subcutaneous passages by sight.
Scabies causes intense itching, which forces young patients to scratch. For this reason, scratches, abrasions and scabs form on their skin.
The scratched lesion is then difficult to identify.

Last but not least, the child's uncooperativeness during visual inspection must be taken into account.
Children are often uncooperative under normal circumstances, let alone when they are nervous and irritated by an itchy condition.

Interesting:
In children, unlike adults, the so-called Darier's sign is sometimes present.
This sign is diagnosed by mechanical irritation of the affected part of the skin.
This swells as a result of the irritation.
This swelling is called urticaria pigmentosa.
Caution!
Urticaria pigmentosa is also present in mastocytosis.

When scabies is suspected on the basis of history and physical examination, microscopic examination is necessary.
With the help of the microscope, the physician obtains direct evidence of the parasite in the skin and can initiate adequate treatment.

How is scabies treated in children?

The treatment of scabies in children is similar to that of adults.
The only problem remains the discipline of the child during treatment and the observance of good hygiene habits.
These aspects are the individual responsibility of each parent.

The mainstay of therapy is the destruction of the scabies, preventive, hygienic and anti-epidemiological measures.
Specific drugs are usually applied in the form of topical ointments and petroleum jelly containing sulphur.
Antihistamines and corticosteroids are used to control allergic manifestations such as itching.
In case of secondary skin infection, treatment with antibiotics is necessary.

The most commonly used preparations for the treatment of scabies

Sulphuris praecipitati is a petroleum jelly containing sulphur. It is used in adults and children. For young children under three years of age, petroleum jelly with a sulphur content of 2.5% is recommended. By the age of six, the sulphur content should not exceed 5%, and by the age of ten, 7.5%. Petroleum jelly with a sulphur content of 10% can only be used in children over 10 years of age. It is used twice a day for 3 to 5 days without bathing. After the treatment, a cleansing bath and washing off any residual petroleum jelly from the child's skin is necessary.

Permethrin 5% cream is used to coat the entire body from the chin down. This 5% preparation can also be used to treat children from two months of age. In children, the most affected part of the face can also be coated, except for the area around the eyes. The cream is left on for about 8 to 12 hours, followed by bathing. In some cases, a single application of the cream is sufficient. If the problem persists, the treatment can be repeated after two weeks.

Ivermectin tablets are tablets that can only be used in children over 5 years of age and in adults. The exact dosage is contained in the written instructions for the medicine. The dosage is different for children and adults, and also depends on the weight of the child and adult. The tablets are usually given as a single dose in an adult, in children it is in three doses. There must be a two-week break between each dose.

In addition to treatment, quarantine and anti-epidemiological measures are necessary

Scabies is a highly infectious disease that spreads relatively rapidly, mainly in community settings.

To prevent this spread and the emergence of a larger epidemic, it is mandatory to report every case of scabies to the regional health station.

In most cases, the report is made by the paediatrician or general practitioner who diagnosed the disease.

The sick child and people who have been in contact with him or her are ordered to be quarantined at home, treated and subjected to strict hygiene and anti-epidemiological procedures.

However, even among us there are those who, out of shame, decide not to take their child to a doctor and try to cure the disease with grandmotherly recipes.

In doing so, they endanger not only their child, but also themselves, other relatives, other children in the nursery...