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Neonatal scabies
1Department of Dermatology, Casa Sollievo della Sofferenza Hospital--IRCCS, San Giovanni Rotondo, Italy.
Insights
Infants treated with topical steroids developed severe Norwegian scabies due to weakened immune responses. This highlights a potential risk of long-term steroid use in young children.
Area of Science:
- Dermatology
- Pediatrics
- Immunology
Background:
- Scabies is a common parasitic infestation.
- Norwegian scabies is a severe form of scabies.
- Topical steroids are frequently used to treat inflammatory skin conditions in infants.
Purpose of the Study:
- To investigate the link between topical steroid use and Norwegian scabies in infants.
- To understand the role of immune suppression in severe scabies presentations.
Main Methods:
- Retrospective case series analysis.
- Evaluation of eleven infants hospitalized for scabies.
- Review of treatment history, focusing on topical steroid use.
Main Results:
- Eleven infants (2-9 months) were diagnosed with scabies.
- Six infants presented with Norwegian scabies.
- These six infants had received prolonged topical steroid treatment for presumed atopic dermatitis.
Conclusions:
- Prolonged topical steroid use in infants may lead to localized immune suppression.
- This immune suppression can facilitate the development of Norwegian scabies.
- Caution is advised regarding long-term topical steroid application in infants with inflammatory skin conditions.
Abstract:
Between 1981 and 1991, eleven infants (ranging in age from 2 to 9 months) were hospitalized in our department for evaluation of microscopically verified scabies infestations. Six presented signs of Norwegian scabies. All of the latter infants had been treated (prior to the scabies infestation) for long periods with topical steroids, in most cases for lesions suggestive of atopic dermatitis. We believe that the occurrence of the Norwegian form in these newborns was due to localized steroid-induced suppression of the normal immune response.