Scabies — DCH MCQ

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EasyCommon childhood illnessesScabiesDCH

A 7-year-old girl has widespread itch, worse at night, and papules in the finger webs and wrists. Her younger brother has similar itching; there is no fever or mucosal involvement. What is the most likely diagnosis?

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Correct answer: B — Scabies

The most likely diagnosis is scabies. The discriminating features are intense nocturnal pruritus, papules in the interdigital spaces and wrists, and similar itching in a household contact. Molluscum contagiosum causes discrete, usually asymptomatic umbilicated papules rather than widespread nocturnal itch. Atopic eczema may be intensely itchy but typically has an eczematous, often flexural distribution and does not cause household clustering. Impetigo produces superficial erosions and honey-coloured crusts. Urticaria causes transient, migratory wheals rather than persistent web-space papules. If treatment is initiated, household contacts should be treated simultaneously to reduce reinfestation.

Reference: NHS, Scabies, Symptoms and treatment sections, last reviewed 21 November 2023. https://www.nhs.uk/conditions/Scabies/