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Review
. 2016 Jun 16;10(6):e0004691.
doi: 10.1371/journal.pntd.0004691. eCollection 2016 Jun.

Scabies: Advances in Noninvasive Diagnosis

Giuseppe Micali  1 , Francesco Lacarrubba  1 , Anna Elisa Verzì  1 , Olivier Chosidow  2 , Robert A Schwartz  3
Affiliations
Review

Scabies: Advances in Noninvasive Diagnosis

Giuseppe Micali et al. PLoS Negl Trop Dis. .

Abstract

Scabies is a common, highly contagious skin parasitosis caused by Sarcoptes scabiei var. hominis. Early identification and prompt treatment of infested subjects is essential, as missed diagnosis may result in outbreaks, considerable morbidity, and significantly increased economic burden. The standard diagnostic technique consists of mites' identification by microscopic examination of scales obtained by skin scraping. This is a time-consuming and risk-associated procedure that is also not suitable to a busy practice. In recent years, some advanced and noninvasive techniques such as videodermatoscopy, dermatoscopy, reflectance confocal microscopy, and optical coherence tomography have demonstrated improved efficacy in the diagnosis of scabies. Their advantages include rapid, noninvasive mass screening and post-therapeutic follow-up, with no physical risk. A greater knowledge of these techniques among general practitioners and other specialists involved in the intake care of overcrowded populations vulnerable to scabies infestations is now viewed as urgent and important in the management of outbreaks, as well as in consideration of the recent growing inflow of migrants in Europe from North Africa.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Sarcoptes scabiei observed by videodermatoscopy at X400 magnification.
The mite, localized at the end of the burrow, has a roundish body and pigmented head (arrowhead) and anterior legs (arrow).
Fig 2
Fig 2. A skin area affected by scabies observed using a low-cost videomicroscope at X150 magnification.
Both the burrow and the mite (arrow) are clearly evident.
Fig 3
Fig 3. Burrow observed by dermatoscopy at X10 magnification.
The jet-shaped triangular structure corresponds to the pigmented anterior part of Sarcoptes scabiei (arrow).
Fig 4
Fig 4. Sarcoptes scabiei observed at the end of a burrow by handheld confocal microscopy.
The technique enables a detailed visualization of the head (arrowhead) and of the anterior legs (arrows). The feces appear as high-refractive roundish structures (circle).
See this image and copyright information in PMC

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