Many children are undoubtedly misdiagnosed as having scabies and treated with lindane or permethrin without any confirmatory scrapings. No other infectious agent has been documented. Cultures and smears will help rule out an infectious etiology. A unilocular, subcorneal or intraepidermal pustule containing polymorphonuclear neutrophils or eosinophils is characteristic. There may be papillary dermal edema and a mild perivascular, mostly lymphocytic, infiltrate in the dermis.
Direct immunofluorescence is negative.
Treatment is often unnecessary due to the self-limited nature of this condition. Topical steroids and oral dapsone have been used with good success, if justified in more difficult cases. Topical pramoxine preparations are available without prescription for treatment of pruritus. Oral antihistamines may be useful. Extremely symptomatic children may be treated with dapsone.