Childhood Scabies

A Narrative Review of the Literature

Abstract

Scabies is an ectoparasitic infestation characterized by erythematous papules, serpiginous

burrows, and intense pruritus, especially at night. Diagnosis is established through correlation

between clinical findings from physical examination and complementary methods, both invasive

and non-invasive, including videodermatoscopy. In childhood, scabies treatment presents

specific challenges, mainly due to the potential adverse effects of ivermectin and permethrin,

which are the first-line drugs for disease management. Worldwide, approximately 300 million

people are affected annually, with infants and young children having the highest incidence rates.

The pediatric population also shows the highest rates of complications and disease burden, often

accompanied by secondary bacterial infections caused by Streptococcus pyogenes or

Staphylococcus aureus. The objective of this study was to conduct a narrative review of recent

scientific literature on childhood scabies, with an emphasis on management, addressing its

epidemiological, clinical, diagnostic, and therapeutic aspects. Based on the literature review, we

observed that complications of scabies in children are often associated with hypersensitivity

reactions. Growing evidence indicates the occurrence of a self-limited, non-contagious

hypersensitivity reaction after treatment, characterized by persistent pustules on the palms and

soles, without the presence of burrows or mites, known as infantile acropustulosis. However, the

scarcity of randomized, multicenter studies with representative samples highlights the need for

further research to clarify these mechanisms and guide effective therapeutic strategies.

Keywords: Scabies, sarcoptic mange, children, pediatric management.