Characterized by extremely pruritic discrete and confluent vesiculopustular acral lesions appearing in crops every 2 to 4 weeks, acropustulosis of infancy is an idiopathic dermatosis that may begin any time from birth to first year of life. The 1-mm to 3-mm red papules change within a 24-hour period into papulovesicular and vesiculopustular lesions, followed by healing with scaling, post-inflammatory hyperpigmentation and sometimes signs of secondary infection. Scabies in infants can often manifest as vesiculopustular lesions on hands and feet, but the predominance of lesions on acral sites, the absence of affected contacts, and the lack of evidence of infestation by microscopic examination help to distinguish infantile acropustulosis from scabies. Moreover, many children diagnosed with infantile acropustulosis may have already been treated for scabies prior to diagnosis, with lesions persisting or recurring despite therapy.
Ref: Janjua SA, Khachemoune A. What caused this pruritic eruption? Scabies.Skin & Aging. 2005 Jan; 13(1): 66-70.