A 7 month old infant is brought to clinic with itchy erythematous papules and vesicles over palms and soles. On examination, serpentine threadlike lesions and eczematous, crusted lesions were noted over face and trunk. Mother gives a history of similar lesions in other family members. What is the most probable diagnosis?
The skin lesions present in the child and history of similar lesions seen in other family members are suggestive of scabies caused by Sarcoptes scabiei. The primary lesions associated with it are burrows, papules and vesicles. In adults lesions are typically seen in webs, wrists, ulnar aspect of forearm, breasts, scrotum and penis. In adults face, palms and soles are spared but are charecteristically involved in infants. If the question contains a history of bronchial asthma in mother or siblings then the diagnosis is atopic dermatitis. In infantile eczema, lesions are not present in the palms and soles. Infantile seborrheic dermatitis is most prevalent in the first 3 months of life and usually dissipate by 1 year. Ref: Illustrated Synopsis of Dermatology and Sexually Transmitted Diseases By Neena Khanna 2ND edn page 289.
Atopic dermatitis
Scabies
Papular uicaria
Seborrheic dermatitis