Question about scabies/post scabies eczema

[worrymama]

My 2/12 year old daughter was treated for scabies on 1/9 and again 1/16.  When she didn't get much better, we took her to a dermatologist who did not find any mites in the scrapings but advised a second course of treatment with Elimite, this time 5 days apart.  (Both times we treated the whole family even though the rest of us did not have symptoms, and we did all the laundry/bedding on hot etc.)  Her last treatment was on 1/31.  It is now 3/6 and over the past week and a half she has had an increase in itching again.  Periodically she has flare ups of red bumps in different places (where the rash was before).  We took her back to the dermatologist who did another scraping and found no mites but could not confirm that it wasn't a reinfestation. We are supposed to wait and see.  Currently she has several somewhat raised bumps on the tops of her thighgs that are only slightly pink (but sometimes some of them will look red, then die back down).  She has similar bumps on the backs of her elbows.  She has a few very light pink bumps on her stomach.  You can see other flat looking bumps in direct, natural light where she used to have an angry looking red rash.  She also has dry, flakey looking skin on the tops of her legs and behind her ears.   Sorry to ramble - my questions are these:

Could it be post scabies eczema?  What does post scabies eczema look like?  And when might we hope that this will resolve?  I'm grateful for any help.  I know in the scheme of things this might not seem like a major crisis, but it has been a very unpleasant ordeal for her and for us.

[Alan Rockoff, MD]

I am very skeptical of the diagnosis.  When a baby has scabies, someone in the family--usually the mother--has symptoms too.  It's all right to treat scabies presumptively--without certain confirmation--but if the baby doesn't get better, then it's time to reconsider the diagnosis.  Perhaps your child just has regular eczema, which could behave exactly as you describe.  Whether or not that was the diagnosis to begin with, you need to have someone a fresh look.  If it is infantile eczema, it should be easy to control, and you won't have to think about bugs you may not even have.



Take care.



Dr. Rockoff