Conclusion and Lessons Learned

The diagnosis of CS can be challenging, especially in patients who are unable to communicate their symptoms such as in children with Down syndrome and autism. In addition, Down syndrome and autism patients have an immune deficiency, which may lead to a more severe form of scabies, CS. Although steroids are often used in dermatological conditions, the steroids provided to this patient only provided temporary improvement and may have exacerbated the condition. In this case, early referral to a dermatologist may have led to diagnosis and appropriate therapy, thus limiting the course of the disease. Without adequate treatment, secondary infections can develop leading to bacteremia and sepsis in up to 8.8% of patients and should initially be treated with antibiotics against streptococcus and staphylococcus.