The whole family scratched together, it turned out that "eczema" was the problem

A new mother from Huairou, Beijing, brought her six-month-old baby, Pudding (Xiaobao's pseudonym), to the Dermatology Department of Beijing Children's Hospital for treatment. As soon as she entered the hospital, Pudding's mother cried and said, "Doctor, please take a look at the child. Why is the eczema so stubborn? We have been to all the local hospitals and have taken medicine for a month, but it has not improved. The child cries every night, and you see, he has not gained any weight. We are so worried!"

Doctor Zhang Bin calmed the mother down a little and asked about her medical history. He found out that Pudding had eczema a month ago and it gradually got worse, especially at night. A month ago, a nanny came from her hometown and claimed to have some eczema. After that, Pudding started to have eczema symptoms and her family members also suffered from eczema. The whole family scratched at night. They took oral antihistamines and topical eczema drugs in many hospitals, but there was no improvement. What's worse is that Pudding had severe itching at night and his growth and development had been affected recently, so he rushed to the hospital.

After examination by the doctor, it was confirmed that Pudding was suffering from "scabies". Dr. Zhang Bin said that the biggest characteristic of the place with scabies is that it itches obviously at night. In addition to the widespread eczematous skin lesions on the trunk and limbs, some important manifestations of adult scabies that are different from eczema are easy to find: the rash is more concentrated in the tender skin areas such as the fingers, wrist flexion, elbow fossa, navel, and lower abdomen belt area, and some needle-sized papulovesicles and tunnels in the epidermis can be seen in the fingers. On the skin of the scrotum and penis, brown-red or flesh-colored nodules ranging in size from soybeans to peanuts can be seen, some of which are harder; although the rash on the body is very severe, the head and face can be completely normal. However, because the affected parts of infant scabies are not as typical as those mentioned above, they are only more obvious in the neck, armpits, palms, and soles, and often show eczematous reactions, so it is easier to misdiagnose and ignore.

Doctor Zhang Bin said that scabies is a chronic infectious skin disease caused by scabies parasitizing the human epidermis. With the improvement of people's living conditions and the improvement of personal hygiene awareness, the incidence of scabies has gradually decreased, but because it rarely occurs, it is easy to be misdiagnosed as "eczema" or "allergic dermatitis" in clinical practice, which delays the condition. Because scabies can parasitize the human body and be transmitted through clothing, bed sheets, bedding and close contact, it is very easy to spread among family members. Therefore, if you find that someone living together has an itchy rash, you should seek medical attention in time.

Treatment method: Children can choose 5% sulfur ointment (10% concentration for adults), which should be applied to the skin from the neck down, including the fingers, scrotum and other parts, once a day for 3 consecutive days, and take a bath and change clothes on the 4th day. All clothes and sheets that come into contact with the patient should be boiled and disinfected, and then dried for 2 weeks before use. Glucocorticoid ointment can be used appropriately for the area with scabies nodules. If the child has severe itching, antihistamines can be given to relieve itching.

It's winter now, and Dr. Zhang Bin reminds parents that if they find that their children are itching after contact with outsiders, and their family members also have similar symptoms, as well as the special rashes mentioned above other than the general "eczema", they should consider the possibility of scabies and go to a regular professional pediatric dermatology department in time to rule out the possibility of scabies.