Question:
A child has multiple itchy papular lesions on the genitalia and fingers. Similar lesions are also seen in the younger brother. Which of the following is the most possible diagnosis?
A child has multiple itchy papular lesions on the genitalia and fingers. Similar lesions are also seen in the younger brother. Which of the following is the most possible diagnosis?
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Finger webs plus genitalia plus a sick sibling points to a contagious mite infection.
Updated On: Jul 8, 2026
- Papular urticaria
- Scabies
- Atopic dermatitis
- Allergic contact dermatitis
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The Correct Option is B
Solution and Explanation
Step 1: Understanding the Question:
A child has itchy papules over the genitalia and fingers, and the same problem has appeared in the younger brother. We need to pick the diagnosis that best fits this pattern.
Step 2: Key Formula or Approach:
Two clues point strongly to one diagnosis: the exact sites involved (finger web spaces and genitalia are classic scabies sites) and the fact that a sibling in the same house has developed identical lesions. Scabies spreads by close skin contact within a household, so more than one family member falling ill at the same time is a strong pointer to it.
Step 3: Detailed Explanation:
Papular urticaria comes from an allergic reaction to insect bites and usually appears on exposed areas like the arms and legs, not typically the genitalia, and it does not spread from person to person within a house. Atopic dermatitis affects flexures like the elbow and knee creases and the face, and is a personal allergic skin tendency, not something that jumps from one sibling to another over days. Allergic contact dermatitis needs contact with a specific irritant or allergen and would not explain why an unrelated younger brother developed the same pattern on the same body sites.
Scabies, caused by the mite Sarcoptes scabiei, classically involves the finger webs, wrists, genitalia, and skin folds, causes intense itching that is worse at night, and spreads easily between people sharing a bed or close contact, which is exactly why the sibling is also affected.
Step 4: Final Answer:
The most likely diagnosis is scabies, based on the classic sites involved and spread to a close contact in the same household.
A child has itchy papules over the genitalia and fingers, and the same problem has appeared in the younger brother. We need to pick the diagnosis that best fits this pattern.
Step 2: Key Formula or Approach:
Two clues point strongly to one diagnosis: the exact sites involved (finger web spaces and genitalia are classic scabies sites) and the fact that a sibling in the same house has developed identical lesions. Scabies spreads by close skin contact within a household, so more than one family member falling ill at the same time is a strong pointer to it.
Step 3: Detailed Explanation:
Papular urticaria comes from an allergic reaction to insect bites and usually appears on exposed areas like the arms and legs, not typically the genitalia, and it does not spread from person to person within a house. Atopic dermatitis affects flexures like the elbow and knee creases and the face, and is a personal allergic skin tendency, not something that jumps from one sibling to another over days. Allergic contact dermatitis needs contact with a specific irritant or allergen and would not explain why an unrelated younger brother developed the same pattern on the same body sites.
Scabies, caused by the mite Sarcoptes scabiei, classically involves the finger webs, wrists, genitalia, and skin folds, causes intense itching that is worse at night, and spreads easily between people sharing a bed or close contact, which is exactly why the sibling is also affected.
Step 4: Final Answer:
The most likely diagnosis is scabies, based on the classic sites involved and spread to a close contact in the same household.
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