Common napkin rash. Severe itch which is worse at night. Rash which may be manifested as blisters, burrows, excoriated papules, impetigo or patches of eczema at the sites of mite infestation. These include wrists, elbows, anterior axillary folds, between fingers, palms and soles in babies, nipples and penis. The rash is often present in contacts because the infestation is caught by close physical contact.
Management Treat the patient and all close contacts.
Its safety in infants under 2 months old is not established and in the very young infant the treatment of choice is precipitated sulphur. Apply it all over from the neck down. This must include between the fingers, between the toes, in the groin, and all over the back. Leave on for 24 hours. Repeat the application one week later in the same way.