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Crusted scabies in children in France: a series of 20 cases

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Abstract

To evaluate the risk factors for crusted scabies in children in France. The retrospective multicenter study, conducted in France, of children (aged < 18 years) with profuse and/or crusted scabies confirmed by dermoscopy and/or microscopy. Data were obtained using a standardized questionnaire. We included 20 children. The mean age was 4.5 years, and 70% of the patients were girls. Their medical history revealed a neurological pathology (agenesis of the corpus callosum; n = 1, 5.0%), prematurity (n = 1, 5.0%), Down syndrome (n = 1, 5.0%), atopic dermatitis (n = 2, 10%), and asthma (n = 2, 10.0%). Fifteen (75.0%) children were treated with steroids before being diagnosed with scabies: 12 (60.0%) with topical steroids, one (5.0%) with a systemic steroid, and two (10.0%) with inhaled steroids. One child (5.0%) lived in a precarious environment. The mean duration of pruritus was 3.4 months, and that of the skin lesions was 3.1 months. The most commonly affected areas for crusted scabies were the palms/hands (66.7%) and the armpits (33.3%). Thirteen children (65.0%) were hospitalized, 14 (70.0%) were treated with ivermectin and all received topical treatments; 85.7% were cured within an average of 38 days, but one child had a relapse 3 months later in the form of common scabies.

Conclusion: The main risk factor for developing crusted scabies in France was the misdiagnosis and the use of corticosteroids, especially topical forms typically used in “healthy” children. Management of the children was effective and similar to that used in adults.

What is Known:

• Crusted scabies is an extremely contagious disease which is rarely reported in infancy, especially in healthy children.

• The main risk factors include immunosuppression, physical debilitation, and intellectual disability.

What is New:

• The main risk factor of severe scabies in this study was delayed diagnosis associated with the use of topical or systemic corticosteroids.

• The treatment was successful in 85.7% of cases, and 65% of children needed to be hospitalized.

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Abbreviations

n (%):

Number and percentage of patients

No.:

Number

SD:

Standard deviation

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Acknowledgements

We are grateful to Emma Pilling, PhD (Santé Active Edition/Synergy Pharm), for the English editing service funded by hospital Victor Dupouy (Argenteuil France). We also thank the Groupe de Recherche de la Société Française de Dermatologie Pédiatrique for its contribution.

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Authors and Affiliations

  1. Dermatology Department, Hôpital Victor Dupouy, Argenteuil, Paris, France

    Camille Grodner & Emmanuel Mahé

  2. Paediatric Dermatology Unit, Pierre University Hospital, SaintSaint-Pierre, la Réunion, France

    Juliette Miquel

  3. Dermatology Department, Hôpital Necker-Enfants Malades, Assistance Publique – Hôpitaux de Paris, Paris, France

    Smaïl Hadj-Rabia

  4. Dermatology Department, Hôpital de La Timone, Aix-Marseille Université, Assistance Publique Des Hôpitaux de Marseille, Marseille, France

    Stéphanie Mallet

  5. Dermatology Department, Hôpital Pellegrin, University Hospital of Bordeaux, INSERM U1035, Bordeaux, France

    Franck Boralevi

  6. Department of Dermatology, Centre de Référence Des Maladies Rares de La Peau, ERN-Skin, Larrey Hospital, Paul Sabatier University, Toulouse, France

    Juliette Mazereeuw-Hautier & Nacer Benzebouchi

  7. Dermatology Department, Centre Hospitalier William Morey, Chalon-sur-Saône, France

    Marie Dhers & Elisa Goujon

  8. Pediatric Department, Hôpital Victor Dupouy, Argenteuil, Paris, France

    Philippe Bensaïd

Authors
  1. Camille Grodner
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  2. Juliette Miquel
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  11. Emmanuel Mahé
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Contributions

Camille Grodner collected the data, performed the analysis, and wrote the paper; Emmanuel Mahe conceived and designed the analysis and contributed data or analysis tools; Juliette Miquel, Smaïl Hadj-Rabia, Stéphanie Mallet, Franck Boralevi, Juliette Mazereeuw-Hautier, Nacer Benzebouchi, Marie Dhers, Elisa Goujon, and Philippe Bensaïd contributed data or analysis tools.

Corresponding author

Correspondence to Camille Grodner.

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Ethics approval

In France, retrospective research on previously collected data (other than genetic) does not come under the Jardé law and is governed by the 1978 data protection law, updated by the application decree of December 2016 and the law No. 2018–493 of June 20, 2018, on protection of personal data. The protection of personal data has been done accordingly.

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The authors declare no competing interests.

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Communicated by Nicole Ritz

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Grodner, C., Miquel, J., Hadj-Rabia, S. et al. Crusted scabies in children in France: a series of 20 cases. Eur J Pediatr 181, 1167–1174 (2022). https://doi.org/10.1007/s00431-021-04251-4

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  • DOI: https://doi.org/10.1007/s00431-021-04251-4

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