A 14-month-old boy has intense nocturnal itching of 4 weeks duration. Examination shows serpiginous grey burrows on the palms and soles, papules on the trunk, and firm nodules in the axillae and groin. His father has similar itching. What is the drug of choice?

• A Oral ivermectin single dose
• B Oral albendazole for five days
• C 10% sulphur ointment for three days
• D 5% permethrin cream applied overnight, repeated once after a week ✓

Explanation

Burrows plus household contacts confirm scabies; in infants, palms, soles, face and scalp are characteristically involved, unlike adults. First line is 5% permethrin applied below the chin in older children but over the entire body including face and scalp in infants, washed off after 8 to 12 hours and repeated after one week. Ivermectin is not recommended under 15 kg, and sulphur is a weaker alternative used when permethrin is unavailable.

Reference: Nelson Textbook of Pediatrics, 21st ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.