Retrospective analysis of child patients diagnosed with scabies, which is frequently confused with atopic dermatitis, in the Şırnak region

Objective: This study examined patients referred to the pediatric and pediatric allergy departments of Şırnak State Hospital with preliminary diagnoses of scabies and atopic dermatitis, who were diagnosed with scabies and underwent treatment, as well as the applied treatment and treatment responses. The aim of this study was to contribute to the literature. Materials and Methods: Data from 77 pediatric patients aged 0–18 years who were referred to the Pediatric Allergy and Immunology and Pediatric Health and Diseases outpatient clinics of Şırnak State Hospital with a preliminary diagnosis of scabies or atopic dermatitis between May 2025 and November 2025 were retrospectively reviewed. Demographic characteristics, household size, bed sharing, nocturnal itching, family history of similar complaints, treatment adherence, treatment use by all individuals in the household, hygiene practices, and clinical treatment response were evaluated. Results: The study included a total of 77 child patients, 29 of whom were girls (37.7%) and 48 were boys (62.3%). The youngest patient was 1 year old and the oldest was 17 years old. A total of 35.1 of the cases were treated with a diagnosis of atopic dermatitis at the initial presentation. Itching that woke the patient from sleep at night was observed in 77.9%, and a family history of similar complaints was observed in 67.5%. Bed sharing was observed in 28.6%, and dormitory living in 9.1%. The rate of patients who achieved clinical benefit from Scabies treatment was 59.7%. While no treatment success was achieved in patients who shared a bed, clinical improvement was observed in 83.6% of those who did not share a bed (p<0.001). Failure to use the treatment together among all individuals in the household and failure to comply with hygiene measures were significantly associated with treatment failure (p<0.001). In the logistic regression analysis, household size and a diagnosis of AD at the initial presentation were significantly associated with treatment failure (B = 3.763, p < 0.001 and B = 8.477, p = 0.022, respectively). Conclusion: The most important determinants of treatment failure in children with scabies are crowded household structure, bed sharing, failure to treat all individuals in the household simultaneously, and inadequate hygiene practices. Cases confused with atopic dermatitis lead to delays in diagnosis. Early diagnosis, correct treatment, and simultaneous treatment of all contacts are critically important in controlling the disease.