SCABIES-SKIN INFECTION IN KIDS
The child may be brought only for the symptoms of skin disease or for symptoms of skin disease which may be associated with other illnesses like gastro-enteritis, marasmus, etc. Sound knowledge of common skin diseases during childhood will certainly help the General Practitioner in managing pediatric cases in a better way. Common skin diseases during childhood are scabies, fungal infection, dermatitis and bacterial infection.
SCABIES-SKIN INFECTION IN KIDS
It is one of the most contagious diseas- es. It is caused by the mite, Sarcop- tes Scabiei. Infection mainly spreads through direct contact. It is most commonly observed in children living in slums. Since it is a contagious disease it is also quite common in children at- tending Municipal Schools or children who are looked after by servants. Sometimes whole family comes for the treatment of scabies.
SIGN AND SYMPTOMS -SCABIES-SKIN INFECTION IN KIDS
1. Itching: This is the most disturbing symptom of the disease. Itching is more at night time.
2. Skin lesions: Commonly affected parts are webs of the fingers, groins, anterior axillary folds, flexor aspect of wrist and elbow, thighs, legs and genitalia. The skin lesion may present as slightly elevated grayish tortuous or dotted line in the skin. Female mite lav eggs in the tortuous tunnel which gives rise to severe itching. In children along with above mentioned organs, even face, palm and sole are involved. In advanced cases it may form follicle or pustule.
Complications of Scabies
1. Secondary bacterial infection
3. In rare cases scabies may lead to glomerulonephritis.
DIAGNOSIS OF SCABIES-SKIN INFECTION IN KIDS
It is not always easy to differentiate between insect bite allergy and scabies. Other differential diagnosis are urticaria, eczema, lichen planus.
At General Practitioner’s level this is one of the most difficult diseases to manage. Parents usually do not accept the concept of full family’s treatment and at the same time they want dramatic relief for their child’s illness. Many a time this disease linger on for days together because all family members are not treated at a time.
MANAGEMENT OF SCABIES-SKIN INFECTION IN KIDS
1. Parents should be explained about the nature of the disease and need to treat all family members at a time.
2. If there is any associated secondary infection, it should be treated first and then treatment for scabies should be started.
3. All clothes, towel, bed linen should be washed with boiled soap water.
TREATMENT OF SCABIES-SKIN INFECTION IN KIDS
If secondary infection is present treat it with antibiotic: Syr. Eryth- romycin 25 to 40 mg/kg/day in divided doses for 5 to 7 days or Ind. Procaine Penicillin 50,000 units/kg/ day after test dose, daily for 5 to 7 days. Other drug which an also used Azithromycin, Amoxycillin, Clarithrocin, Cefixime.
2.Treatment of SCABIES-SKIN INFECTION IN KIDS
Following medicines can be used for local application. a. Gama Benzene Hexachloride 1% Lotion (Gamascab): Odorless and nonirritant lotion can be applied even on face. It is also available in cream form. OR b. Benzyl Benzoate lotion (Scabo- ma): 25% Benzyl Benzoate lotion be applied below neck, all over the body. It should be applied 3-4 time at the interval of 12 to 24 hours, with bath- ing and scrubbing of the body before and after the complete course. In infants and small children half diluted lotion should be used. OR C. Sulfur Ointment: For children 2.5% sulfur ointment is used. The only practical problem is that it stains the cloth.
d. Permethrin (Permed) cream and lotion for L.A. 3. Supplementary Treatment: For itching- Tab. Chlorpheniramine maleate- 0.35 mg/ kg/day in divided doses till the symptom subside. 4. Permed soap OR Sulphur soap for bath.