Clinical Features and Epidemiological Characteristics of Scabies in Pediatric Patients: A Retrospective Study

Abstract

Anass ABBOUR, Fatima Zahra ELFATOIKI, Fouzia HALI, Maha SOUSSI ABDALLAOUI and Soumiya CHIHEB

Introduction: Scabies, a highly contagious skin infestation caused by Sarcoptes scabiei, affects approximately 200 million individuals globally, with a higher prevalence in socioeconomically disadvantaged populations. While adults typically present with intense pruritus and characteristic rashes, pediatric cases, especially in infants, present with more varied lesions and often lack typical pruritus.

Objective: This study aims to provide a comprehensive analysis of the clinical, epidemiological, and therapeutic aspects of pediatric scabies, focusing on age-related variations in presentation, diagnostic delays, and factors influencing treatment response.

Materials and Methods: A retrospective observational study was conducted over a six-year period (January 2018 to January 2024), analyzing pediatric scabies cases managed in dermatology consultations. Data collected included demographics, clinical presentations, diagnostic methods, treatment protocols, and outcomes. Statistical analyses were performed to compare differences between infants (<24 months) and older children (>24 months).

Results: A total of 148 pediatric cases were collected, with 50 infants (33.8%) and 98 older children (66.2%). The median age of patients was 6.2 years, and the male-to-female ratio was 1.15. The consultation delay ranged from 5 days to 7 months, with a family history of pruritus in 77.7% of cases, predominantly maternal in infants (84.5%). Infants exhibited more severe forms, such as pseudo-erythrodermic scabies (12%), while older children presented with classic scabies signs, including burrows (30.6%) and impetiginized scabies (24.5%). Diagnostic methods, including skin scrapings, tape tests, and dermoscopy, revealed varying sensitivities, with dermoscopy showing a Delta-wing sign in 67,3% in infants compared to 15.3% in older children. Benzyl benzoate was the primary treatment, with adjunctive therapies including antihistamines and emollients.

Conclusion: Pediatric scabies presents distinct diagnostic challenges, especially in infants, where atypical presentations and delayed diagnosis are common. Increased awareness, effective treatment protocols, and enhanced caregiver education are crucial to improving outcomes and preventing recurrences, particularly in socioeconomically disadvantaged populations.

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