At this time, although the subjective complications are greatest, few mites remain since they are eradicated by the allergic response. The eruption caused by scabies is extremely itchy, especially at night. The rash s distribution in infants, primarily involves the face, palms, and soles, while older children and adults usually have the greatest concentration of burrows in the finger webs, wrist folds, axillae, umbilicus, groin and genitals. In infants, the lesions are often vesicular. Secondary staphylococcal infection may occur especially when the infected individual is unable to resist scratching.
Infected lesions are often painful and have oozing and yellow crust formation.
Management Being one month of age, Paco is especially at risk for systemic bacterial infection. Had he been febrile, or toxic appearing, admission for a septic work up and intravenous antibiotics may have been warranted. Since he was afebrile and well appearing such measures would not be deemed necessary. Treatment of the scabies was reserved until the secondary staphylococcal infection was resolved. The lotion should be washed off the following morning.