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Dermatology  (Expert Forum)
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Follow-up to question about scabies/post scabies eczema
Answered by
Alan Rockoff, MD - dermatology, Child Skin Problems
The Rockoff Dermatology Center Brookline - MA
Welcome to the DERMATOLOGY FORUM! Questions in this forum are answered by Dermatologists from St. Luke's Roosevelt Hospital, under the direction of Andrew Alexis, M.D., M.P.H.

Follow-up to question about scabies/post scabies eczema

by worrymama, Mar 07, 2006 12:00AM
Thanks so much for your reply.  It is frustrating that we couldn't get a definitive diagnosis (the dermatologist diagnosed scabies because he said he simply didn't have a better diagnosis and it looked "scabies-like" under the light).  I was skeptical too, especially since her rash went untreated for over 2 weeks and no one else got it.
Just a little more info:
Her rash has improved since we did the treatments, but it hasn't resolved completely (I'd say she is 50% better).  I don't know if her improvement is because of the elimite, the passage of time, or the hydrocortisone cream we apply occasionally.
Also, she had some itching when it was at its worst(she used to scratch at her inner forearm quite a bit) but not the severe itching usually associated with scabies.  Her recent return to scratching is what has me worried.
So my follow-up questions are:
Assuming it was scabies at one time, is it possible for 4 applications of elimite and/or the breaking down of dead mites in the skin to cause the eczema-like condition that she has now?
And assuming it was never scabies, should I consider that the original intensity of her condition could have been caused by some external irritant?  Or a virus that did not have any other symptoms?  Or an allergy to our dog?

I will seek out a second opinion from another dermatologist but am grateful for any additional insight you may have before I do.  And thanks again.

by Alan Rockoff, MD, Mar 08, 2006 12:00AM
Everything you say reinforces my hunch that it was eczema ll along.  Elimite can be irritating in the short term, but it does not cause long-term, much less permanent, changes in the skin.  On the other hand, eczema comes and goes and fluctuates just as you say is happening with your child, so I think that when you see another doctor, that is what you'll hear.

Best.

Dr. Rockoff
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