Two stories beneath the skin: Differential diagnosis of scabies and atopic dermatitis in a pediatric allergy clinic

INTRODUCTION: This study aimed to enhance the differential diagnosis of scabies and atopic dermatitis in pediatric patients by integrating hematologic and epidemiological parameters alongside clinical symptoms.
METHODS: A retrospective review was conducted on 376 pediatric patients (188 with scabies, 188 with atopic dermatitis) who presented with itching and/or rash between December 2023 and December 2024. Age, sex, presenting complaints, complete blood count parameters (neutrophils, lymphocytes, eosinophils, platelets, total leukocytes), and total serum IgE levels were analyzed and compared between groups.
RESULTS: Neutrophil counts, eosinophil percentages, and total IgE levels were significantly higher in the scabies group (p<0.05), while lymphocyte and platelet counts were higher in the atopic dermatitis group (p<0.05). Children with scabies presented at an older age (6.93±4.60 vs. 5.37±4.03 years) and were more likely to be male (p<0.05). “Itching alone” was the most common complaint in scabies, whereas “rash” and “skin thickening” were more frequent in atopic dermatitis. A positive family history was significantly more common in the scabies group (p<0.01).
DISCUSSION AND CONCLUSION: By highlighting distinct distributions of total IgE and basic hematologic markers, this study offers clinically relevant insight into differentiating scabies from atopic dermatitis in children. Demographic variables such as age, sex, and symptom patterns further support diagnostic decision-making in pediatric allergy and primary care settings.

Keywords: Atopic dermatitis, child, differential diagnosis, pruritus, scabies, skin diseases.