Clinical scenario No. 1/3 - Scabies, pediatric clinical case
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last updated on 06/06/2024
Presentation 1/3, initial case :
What treatment and management are needed?
See propositions
×
Therapeutic treatment suggestions
Marie: 3 years, 13kg
- Local treatment:
-
- permethrin 5% cream1
- or
- benzyl benzoate 10% skin emulsion2
- Related environmental measures3
- Simultaneous treatment for the whole family
- Interrupt communal activities (school) for 3 days
Louise: 18 months, 10kg
- Local treatment:
-
- permethrin 5% cream,1 recommended for infants (< 1 year), for damaged skin or if the face is affected, to avoid irritating the skin and mucous membranes
- or
- benzyl benzoate 10% skin emulsion4
- Related environmental measures3
- Simultaneous treatment for the whole family
- Interrupt communal activities (school) for 3 days
Ninon: 6 weeks, 4.5kg
- Consider hospital treatment
- Outpatient or inpatient depending on the context
- Local treatment:
- Permethrin 5% cream1
- Related environmental measures3
- Simultaneous treatment for the whole family
Howto
- Apply a thin layer over the entire body in the evening. Leave on overnight (minimum 8 hours) and rinse off in the morning. Apply on D0 and reapply between D8 and D14.
- Two successive full-body applications (or one application depending on tolerance). Leave on for 24 hours then rinse off. Apply on D0 and reapply between D8 and D14.
- Decontamination of bedding and clothing by machine washing at 50°C or 3 days in a sealed bag, treatment of mattress, furniture and car seats with anti-parasitic spray.
- One full-body application, reduce time on skin to 12 or even 6 hours according to tolerance, then rinse off. Apply on D0 and reapply between
Step 2/3
The family returns 3 months later with the same clinical picture and a recurrence is confirmed.
What treatment and management are needed?
Read the proposition
×
Therapeutic treatment suggestions
If treatment failure for Marie, 3 years, 13kg
After confirming treatment failure and analysing the underlying conditions:
- recontamination, poor compliance, intolerance of local treatment, poor clothing/bedding decontamination, subjects not all treated simultaneously, etc.
- Same product or the other proposed for 1st-line local treatment:
-
- permethrin 5% cream1
- or
- benzyl benzoate 10% skin emulsion2
- or
- ivermectin oral (2 doses: D0 and between D8 and D14, mid meal)
- if compliance is doubtful, the child’s skin condition is poor or in cluster cases
- if the child has not been to a tropical area where there is a risk of helminthiasis
- Related environmental measures and simultaneous treatment for the whole family
If treatment failure for Louise, 18 months, 10kg
After confirming treatment failure and analysing the underlying conditions:
- recontamination, poor compliance, intolerance of local treatment, poor clothing/bedding decontamination, subjects not all treated simultaneously, etc.
- Same product or the other proposed for 1st-line local treatment:
-
- permethrin 5% cream,1 recommended for infants (< 1 year), for damaged skin or if the face is affected, to avoid irritating the skin and mucous membranes
- or
- benzyl benzoate 10% skin emulsion3
- or
- ivermectin oral (2 doses: D0 and between D8 and D14, mid meal)
- if compliance is doubtful, the child’s skin condition is poor or in cluster cases
- if the child has not been to a tropical area where there is a risk of helminthiasis
- Related environmental measures andsimultaneous treatment for the whole family
If treatment failure for Ninon, 6 weeks, 4.5kg
Consider hospital treatment (outpatient or inpatient depending on the context)
After confirming treatment failure and analysing the underlying conditions:
- recontamination, poor compliance, intolerance of local treatment, poor clothing/bedding decontamination, subjects not all treated simultaneously, etc.
- Same local treatment:
-
- Related environmental measures and simultaneous treatment for the whole family
Howto
- Apply a thin layer over the entire body in the evening. Leave on overnight (minimum 8 hours) and rinse off in the morning. Apply on D0 and reapply between D8 and D14.
- Two successive foll-body applications (or one application depending on tolerance). Leave on for 24 hours then rinse off. Apply on D0 and reapply between D8 and D14.
- One full-body application, reduce time on skin to 12 or even 6 hours according to tolerance, then rinse off. Apply on D0 and reapply between D8 and D14.
Step 3/3
If initially, only the parents are affected and the children show no signs of scabies, what treatment and management are needed for the 3 children contact subjects?
What is your proposition?
See proposition
×
Therapeutic treatment suggestions
Marie, 3 years, 13kg
- Local treatment:
-
- permethrin 5% cream1
- or
- benzyl benzoate 10% skin emulsion2
Louise, 18 months, 10kg
- Local treatment:
-
- permethrin 5% cream,1 recommended for infants (< 1 year), for damaged skin or if the face is affected, to avoid irritating the skin and mucous membranes
- or
- benzyl benzoate 10% skin emulsion2
Ninon, 6 weeks, 4.5kg
- No systematic treatment for infants < 2 months, but reassessment at 2-3 weeks.
Associated measures
- Related environmental measures3
w
- and simultaneous treatment for the whole family
Howto
- Apply a thin layer over the entire body in the evening. Leave on overnight (minimum 8 hours) and rinse off in the morning. Apply on D0 and reapply between D8 and D14.
- One full-body application, leave on for 24 hours then rinse off (reduce time on skin to 12 or even 6 hours for infants < 2 years and according to tolerance). Apply on D0 and reapply between D8 and D14.
- Decontamination of bedding and clothing by machine washing at 50°C or 3 days in a sealed bag, treatment of mattress, furniture and car seats with anti-parasitic spray.
➜ Gynecological case
