Atopic Dermatitis vs Scabies
Atopic Dermatitis and Scabies are easy to mix up on the boards. Here's a side-by-side comparison — presentation, workup, imaging, and first-line treatment — drawn from our full outlines.
Atopic Dermatitis vs Scabies at a glance
- Atopic Dermatitis: Chronic relapsing pruritic inflammatory dermatosis driven by skin barrier dysfunction and Th2 immune skewing; part of the atopic march.
- Scabies: Intensely pruritic infestation by Sarcoptes scabiei mite — burrows in web spaces and intensely itchy nocturnal rash; household contacts affected.
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Side-by-side comparison
| Feature | Atopic Dermatitis | Scabies |
|---|---|---|
| At a glance | Chronic relapsing pruritic inflammatory dermatosis driven by skin barrier dysfunction and Th2 immune skewing; part of the atopic march. | Intensely pruritic infestation by Sarcoptes scabiei mite — burrows in web spaces and intensely itchy nocturnal rash; household contacts affected. |
| Classic presentation | Flexural eczematous patches with lichenification in a child or adolescent with personal/family atopy.; Intense pruritus — required feature; often worse at… | Burrows in finger web spaces, flexor wrists, genitalia; intense nocturnal pruritus; multiple affected family members.; Intense generalized pruritus, worse at… |
| Workup / key labs | Hanifin and Rajka criteria (3 major + 3 minor) or AAD simplified criteria. Essential features: pruritus + eczematous dermatitis in age-typical distribution +… | IACS 2020 consensus: confirmed (mite/eggs/scybala visualized), clinical (burrows + classic distribution + 1 history feature), or suspected (typical lesions +… |
| Imaging | Not indicated | Not indicated |
| First-line treatment | Skin barrier repair: emollient/moisturizer (ceramide-containing, petrolatum-based) applied liberally ≥2x/day and immediately after bathing ('soak and seal');… | Topical permethrin 5% cream — apply from neck down (include scalp/face in infants and elderly) overnight (8-14 hours), wash off in morning; REPEAT in 7 days… |
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