Scabies is a skin infestation caused by the mite Sarcoptes scabiei variant hominis, an obligate human parasite. The infestation, whose incidence is often underestimated, is widespread with a higher prevalence within the paediatric age, particularly in children under the age of 2. In young children diagnosis can be challenging because of the differences in appearance and location of skin lesions, especially in the neonatal forms. Neonatal scabies has no treatment approved by European guidelines, and the most widely used drug in infants such as permethrin is off-label under 2 months of age.
This article describes a case of neonatal scabies. The patient presented with vesicle-crusted erythematous elongated lesions on the trunk and papular lesions in the axillary region, with minor involvement of the upper limbs. Clinical suspect was then confirmed through dermatoscopy. 5% permethrin cream was applied for three consecutive days with a 3-hour exposure time. The treatment was repeated one week after the latest application for two consecutive days and was extended to all family members.