A 2-year-old child (A) presents with a 4-day history of a rash limited to the feet and ankles. The papular rash is both pruritic and erythematous. The 3-month-old sibling of this patient (B) has similar lesions also involving the head and neck. The most appropriate treatment for this condition includes which of the following?
(b) Source: (Hay et al, p 393. Kliegman et al, pp 2319-2320. McMillan et al, pp 1382-1383. Rudolph et al, pp 1301-1302.) Scabies is caused by the mite Sarcoptes scabiei var. hominis. Most older children and adults present with intensely pruritic and threadlike burrows in the interdigital areas, groin, elbows, and ankles; the palms, soles, face, and head are spared. Infants, however, usually present with bullae and pustules, and the areas spared in adults are often involved in infants. The clinical manifestations closely resemble those of atopic dermatitis. Gamma benzene hexachloride (lindane) can cause neurotoxicity through percutaneous absorption, especially in small infants and those with abnormal skin (impetigo, etc), and is, therefore, not recommended in children as first-line therapy for scabies. An excellent alternative--5% permethrin cream (Elimite)--is safer and is more often recommended.
Coal-tar soap
Permethrin
Hydrocortisone cream
Emollients
Growth, Development, and Behavior