72. Scabies and Lice

  1. Alan D. Irvine MD, FRCPI, FRCP2,3,
  2. Peter H. Hoeger MD4,5 and
  3. Albert C. Yan MD, FAAP, FAAD6,7
  1. Julie S. Prendiville MB, FRCPC

Published Online: 24 MAY 2011

DOI: 10.1002/9781444345384.ch72

Harper's Textbook of Pediatric Dermatology, Volume 1, 2, Third Edition

Harper's Textbook of Pediatric Dermatology, Volume 1, 2, Third Edition

How to Cite

Prendiville, J. S. (2011) Scabies and Lice, in Harper's Textbook of Pediatric Dermatology, Volume 1, 2, Third Edition (eds A. D. Irvine, P. H. Hoeger and A. C. Yan), Wiley-Blackwell, Oxford, UK. doi: 10.1002/9781444345384.ch72

Editor Information

  1. 2

    Trinity College, Dublin, Ireland

  2. 3

    Our Lady's Children's Hospital, Dublin, Ireland

  3. 4

    University of Hamburg, Hamburg, Germany

  4. 5

    Catholic Children's Hospital Wilhelmstift, Hamburg, Germany

  5. 6

    University of Pennsylvania School of Medicine, Philadelphia, PA, USA

  6. 7

    The Children's Hospital of Philadelphia, Philadelphia, PA, USA

Author Information

  1. Department of Pediatrics, University of British Columbia, and British Columbia's Children's Hospital, Vancouver, Canada

Publication History

  1. Published Online: 24 MAY 2011
  2. Published Print: 3 JUN 2011

ISBN Information

Print ISBN: 9781405176958

Online ISBN: 9781444345384



  • Scabies;
  • head lice;
  • pediculosis;
  • insecticides;
  • ivermectin;
  • wet-combing;
  • Demodex folliculitis


Scabies and lice occur worldwide. In infants and young children scabies nodules and vesiculopustular lesions on the palms and soles are frequently present in addition to widespread excoriated papules, and secondary staphylococcal or streptococcal impetigo is common. A diagnosis of scabies is established by clinical detection of the characteristic burrows and, if possible, microscopic identification of the mite, eggs and scybala. The current treatment of choice is topical permethrin 5% cream, with oral ivermectin an alternative option for recalcitrant cases. Head lice are found commonly in schoolchildren. Extensive use of insecticide treatment has resulted in selection of lice with resistant mutations. As a consequence, there has been considerable interest in development of alternative and physical treatments. Folliculitis caused by the Demodex mite is primarily seen in children with acute lymphoblastic leukaemia on maintenance chemotherapy. The papulopustular eruption on the face and scalp may be resistant to treatment.