Jin Seon Pil, Choi Ji Eun, Won Chong-Hyun, Cho Soyun
Department of Dermatology, Seoul National University Boramae Hospital, Seoul, Korea.
Ann Dermatol. 2009 May;21(2):200-2. doi: 10.5021/ad.2009.21.2.200. Epub 2009 May 31.
Diagnosis of scabies in young children can be challenging since the morphology and distribution of skin lesions may differ from adults. Therefore, clinicians should keep scabies in mind in their differential diagnosis in a child who presents with severe pruritic, polymorphic skin lesions. Regarding the treatment of scabies, the reported clinical experience with gamma benzene hexachloride (lindane) in young children is quite limited because of its neurotoxicity. However, a recent review suggests that lindane is an excellent alternative drug with minimal risk. We report the case of a 2-month-old male infant with pruritic, erythematous macules, papules, nodules, vesicles, and pustules from the top of the head to the tip of the toes. Initially, he was thought to have impetigo and antibiotics were prescribed. After obtaining a careful history and with the use of skin scraping, he was diagnosed with scabies. He was successfully treated with lindane with no adverse reactions.
幼儿疥疮的诊断颇具挑战性,因为其皮肤损害的形态和分布可能与成人不同。因此,对于出现严重瘙痒性、多形性皮肤损害的儿童,临床医生在鉴别诊断时应考虑疥疮。关于疥疮的治疗,由于γ-六氯环己烷(林丹)具有神经毒性,其在幼儿中的临床应用经验相当有限。然而,最近的一项综述表明,林丹是一种风险极小的优秀替代药物。我们报告一例2个月大男婴的病例,该患儿从头到脚出现瘙痒性红斑、丘疹、结节、水疱和脓疱。起初,他被认为患有脓疱疮并使用了抗生素。经过详细询问病史并进行皮肤刮擦检查后,他被诊断为疥疮。他使用林丹成功治愈,且未出现不良反应。