title: [Scabies of the nail unit in an infant].
abstract: BACKGROUND
  There are no guidelines regarding the management of scabies in infants and recurrence is common at this age. We report the case of an infant with subungual hyperkeratosis and ungual lesions subsequent to classic scabies.
  
  
  METHODS
  A 7-month-girl, treated 6 weeks earlier with esdepallethrin for scabies, consulted for acquired lesions on 3 toe nails. These nails were thickened and displayed subungual hyperkeratosis. Physical examination of the skin, the finger nails and mucous membranes was otherwise normal. Fungal analyses were negative, but direct microscopic examination revealed numerous larvae of Sarcoptes scabiei as well as ovular debris. The child was treated with urea 40% to obtain chemical avulsion of the nails, and with topical esdepallethrin and a quarter tablet of ivermectin orally; there was no follow-up of the child.
  
  
  CONCLUSIONS
  Ungual scabies has already been reported in crusted scabies and very rarely in classic scabies. Subungual and ungual locations of S. scabiei may constitute a source of reinfestation with scabies in infants. Treatment is not well defined and currently involves chemical avulsion of the nails and the application of topical antiscabies treatment.
authors.affiliation: Université François-Rabelais de Tours, 37000 Tours, France; Service de dermatologie, unité de dermatologie pédiatrique, CHRU de Tours, 37044 Tours cedex 9, France. Electronic address: antoinefinon@orange.fr.
authors.forename: A
authors.initials: A
authors.lastname: Finon
authors.affiliation: Université François-Rabelais de Tours, 37000 Tours, France; Laboratoire de parasitologie-mycologie-médecine tropicale, CHRU de Tours, 37044 Tours cedex 9, France.
authors.forename: G
authors.initials: G
authors.lastname: Desoubeaux
authors.affiliation: Université François-Rabelais de Tours, 37000 Tours, France; Service de dermatologie, unité de dermatologie pédiatrique, CHRU de Tours, 37044 Tours cedex 9, France.
authors.forename: M
authors.initials: M
authors.lastname: Nadal
authors.affiliation: Service de dermatologie, unité de dermatologie pédiatrique, CHRU de Tours, 37044 Tours cedex 9, France.
authors.forename: G
authors.initials: G
authors.lastname: Georgescou
authors.affiliation: Nail Disease Center, 06400 Cannes, France.
authors.forename: R
authors.initials: R
authors.lastname: Baran
authors.affiliation: Université François-Rabelais de Tours, 37000 Tours, France; Service de dermatologie, unité de dermatologie pédiatrique, CHRU de Tours, 37044 Tours cedex 9, France.
authors.forename: A
authors.initials: A
authors.lastname: Maruani
mesh_terms: D000279:Administration, Cutaneous; D000284:Administration, Oral; D000487:Allethrins / Q000008:administration & dosage*; D000977:Antiparasitic Agents / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007223:Infant; D007559:Ivermectin / Q000008:administration & dosage*; D009262:Nails / Q000187:drug effects* / Q000473:pathology; D010882:Piperonyl Butoxide / Q000008:administration & dosage*; D012532:Scabies / Q000150:complications* / Q000188:drug therapy* / Q000473:pathology; D016896:Treatment Outcome; D014508:Urea / Q000008:administration & dosage*
chemical_list: D000487:Allethrins; D000977:Antiparasitic Agents; C095596:esdepallethin - piperonyl butoxide; D007559:Ivermectin; D014508:Urea; D010882:Piperonyl Butoxide
keywords: Esdépalléthrine; Gale; Infant; Ivermectin; Ivermectine; Nail; Nourrisson; Ongle; Onyxis; Sarcopte; Sarcoptes scabiei; Scabies