SynopsisCodesLook ForDiagnostic PearlsDifferential Diagnosis & PitfallsBest TestsManagement PearlsTherapyReferences

Information for Patients

View all Images (59)

Scabies (pediatric) in Child
See also in: Anogenital
Other Resources UpToDate PubMed

Scabies (pediatric) in Child

See also in: Anogenital
Contributors: Kimberley R. Zakka MD, MSc, Yun Xue MD, Belinda Tan MD, PhD, Nnenna Agim MD, FAAD, Susan Burgin MD
Other Resources UpToDate PubMed


This summary discusses pediatric patients. Scabies in adults is addressed separately.

Scabies is a parasitic infestation of the epidermis. It is caused by the obligate human parasite Sarcoptes scabiei var hominis and is transmitted via direct skin-to-skin contact (usually 10-20 minutes' contact) and rarely by fomites such as bedding and clothing. Scabies affects all ethnic groups and socioeconomic levels. Scabies is most common in young children, and the highest prevalence is seen in children younger than 2 years. It is extremely contagious, spreading between individuals who share close contact or living spaces. Frequent outbreaks occur in schools, group homes, and orphanages where direct contact with infested individuals is common. The most common predisposing factors are overcrowding, poverty, poor nutrition, and being undomiciled. Other predisposing conditions include immunocompromised status, HIV infection, and severe intellectual or physical disability. The highest prevalence of infestation is seen in tropical regions such as Central America, the Northern Territory of Australia, and the Pacific Islands.

Infestation begins with the female mite, which burrows within the stratum corneum of the host and lays its eggs. The eggs develop into larvae, nymphs, and adults. The average number of adult female mites in an infested individual is 10-15, but this number can be much larger in those who are immunocompromised. If separated from human hosts, the mite can survive at most a few days. Symptoms and signs typically develop approximately 3 weeks after the primary infestation.

Clinically, scabies infestation manifests in 3 ways: classic, nodular, or crusted (previously called Norwegian scabies).
  • Classic scabies in children presents with pruritic papules affecting flexural areas, including the axillary folds, wrists, and dorsal ankles; the interdigital web spaces of the hands and feet; anogenital area; and truncal areas, especially around the nipples and periumbilical areas (the circle of Hebra). It is accompanied by itch, which is classically worse at night, especially just after getting into bed.
  • Nodular scabies, a clinical variant of classic scabies, is less common in children than in adults. It is considered a hypersensitivity reaction to the mite and manifests with erythematous nodules.
  • The crusted variant of scabies is most common in individuals who are immunocompromised. It presents with widespread scaly, crusted, or hyperkeratotic papules and plaques. Scales may have a powdery texture. Pruritus may be severe but is usually minimal or absent. Nail dystrophy can be present. It is extremely contagious due to the high mite burden; there may be up to a million mites on a single individual.
Scabies infestation may be complicated by id reactions and secondary bacterial infections with both Streptococcus and Staphylococcus.


B86 – Scabies

128869009 – Infestation by Sarcoptes scabiei var hominis

Look For

Subscription Required

Diagnostic Pearls

Subscription Required

Differential Diagnosis & Pitfalls

To perform a comparison, select diagnoses from the classic differential

Subscription Required

Best Tests

Subscription Required

Management Pearls

Subscription Required


Subscription Required


Subscription Required

Last Reviewed:02/15/2023
Last Updated:04/06/2023
Copyright © 2024 VisualDx®. All rights reserved.
Patient Information for Scabies (pediatric) in Child
Print E-Mail Images (59)
Contributors: Medical staff writer
Premium Feature
VisualDx Patient Handouts
Available in the Elite package
  • Improve treatment compliance
  • Reduce after-hours questions
  • Increase patient engagement and satisfaction
  • Written in clear, easy-to-understand language. No confusing jargon.
  • Available in English and Spanish
  • Print out or email directly to your patient
Copyright © 2024 VisualDx®. All rights reserved.
Scabies (pediatric) in Child
See also in: Anogenital
A medical illustration showing key findings of Scabies (pediatric) : Excoriation, Scattered many, Widespread distribution, Pruritus, Smooth papules, Smooth nodules
Clinical image of Scabies (pediatric) - imageId=1777728. Click to open in gallery.  caption: 'Burrows and pink, scaly papules on the sole.'
Burrows and pink, scaly papules on the sole.
Copyright © 2024 VisualDx®. All rights reserved.