Scabies in a Preterm Infant Younger than 2 Months: What Do We Have?

Objective – To present a case of scabies in a preterm neonate treated with an off-label treatment (oral ivermectin) without any adverse effects.Case Report – A preterm female neonate (29+3 weeks of gestation) was diagnosed with scabies at 35 days of life (34+3 weeks of corrected gestational age), after her parents had been diagnosed, having been admitted at birth to the neonatal unit of a tertiary hospital. Treatment was initiated with topical off-label permethrin 5%, with the informed consent of the parents. Concomitantly with the patient, the parents received treatment with permethrin 5% and oral ivermectin on days 0, 7, 14 and 21 after diagnosis. No adverse effects resulting from the use of these treatments were reported. On physical examination, active lesions due to scabies were still observed two weeks after permethrin treatment, so it was decided to re-administer the treatment with topical 5% permethrin on days 0 and 14, associated with oral Ivermectin at 200μg/kg on days 0 and 7. The treatment was administered to the patient and her entire family. Fourteen days after completion of ivermectin treatment, the patient presented with complete resolution. Conclusion – After our experience with this case, and given the increasing prevalence of scabies in our environment, we propose that ivermectin is a useful alternative in the treatment of scabies in this age group; however, larger series of patients are needed to establish a recommendation in this regard, evaluating its risks and benefits.