• Scabiess requires sensitization to the organism, Sarcoptes scabiei. 
• It may take weeks before pruritus develps in a child infested for the first time.  On the next exposure, however, INTENSE itching will occur within 24 hours. 
• Burrows in the webs of fingers and toes are common.
• Treatment:  Firstline is permethrin 5% cream on the entire body from the neck down, and wash off after 12 hours.  Alternative is lindane 1% (1oz of lotion or 30g of cream) applied in a thin layer over the entire body from the neck down, and thoroughly washed off after 8 hours OR ivermectin 200ug/kg orally repeated in 2 weeks.
• Many avoid lindane because of neurotoxicity.  Do not apply it after a bath, or to someone with extensive atopic dermatitis as seizures have been reported.
• Decontaminate all bedding and cloting.
• Warn patients that the rash and itching may persist for up to 2 weeks after treatment.

References

2006 Report of the Committee on Infectious Diseases.  American Academy of Pediatrics.