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. 2024 Mar 30;14(4):373.
doi: 10.3390/jpm14040373.

Exploring Blood Cell Count-Derived Ratios as Practical Diagnostic Tools for Scabies in Vulnerable Populations

Hoang Thao Giang Nguyen  1 , Ha Long Hai Le  2   3 , Hoang Viet Nguyen  3 , Huyen My Le  2 , Huy Luong Vu  4 , Pleiades T Inaoka  1 , Ota Tetsuo  1 , Quoc Trung Ly  5 , J Luis Espinoza  1
Affiliations

Exploring Blood Cell Count-Derived Ratios as Practical Diagnostic Tools for Scabies in Vulnerable Populations

Hoang Thao Giang Nguyen et al. J Pers Med. .

Abstract

Scabies is a neglected tropical disease and represents a considerable global burden. Although consensus diagnostic criteria for scabies have been recently published, diagnosing scabies infestation remains challenging in clinical practice. We investigated the diagnostic utility of complete blood cell count (CBC) and CBC-derived ratios obtained at diagnosis in a set of 167 patients who are Vietnamese with confirmed scabies. These parameters were compared with those of patients with dermatophytosis (N = 800) and urticaria (N = 2023), two diseases frequent in Vietnam, which can present with similar skin manifestations to scabies and tend to pose a diagnostic challenge in vulnerable populations. Our analysis revealed that white blood cell, monocyte, and eosinophil counts were significantly higher among patients with scabies than the other two diseases. Similarly, the monocyte-to-lymphocyte ratio (MLR) and eosinophil-to-lymphocyte ratio (ELR) were significantly higher among patients with scabies. The optimal cut-off values to distinguish scabies from dermatophytosis and urticaria were 0.094 for ELR (sensitivity: 74.85%, specificity: 70.7%) and 0.295 for MLR (sensitivity: 52.69%, specificity: 73.54%). CBC, ELR, and MLR are low-cost and easily calculated parameters that may be helpful for the diagnosis of scabies.

Keywords: blood cell count; differential diagnosis; eosinophilia; inflammation marker; scabies.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Comparison of scabies, dermatophytosis, and urticaria characteristics. The images at the top are representative skin lesions of patients who are Vietnamese with scabies, dermatophytosis, and urticaria, respectively. Key epidemiological and clinical aspects of each disease are indicated in the bottom panel.
Figure 2
Figure 2
ROC analysis of complete-blood-cell-count-derived ratios to predict scabies. NLR: neutrophil-to-lymphocyte ratio; PLR: platelet-to-lymphocyte ratio; MLR: monocyte-to-lymphocyte ratio; ELR: eosinophil-to-lymphocyte ratio; BLR: basophil-to-lymphocyte ratio.
Figure 3
Figure 3
ROC analysis of white blood cell counts for distinguishing scabies from dermatophytosis and urticaria. The parameters include white blood cells (WBCs); neutrophils (NEUs); lymphocytes (LYMs); monocytes (MONs); eosinophils (EOSs); and basophils (BASs).
Figure 4
Figure 4
ROC analysis of white blood cell percentages for distinguishing scabies from dermatophytosis and urticaria. The parameters include the percentage of lymphocytes (LYM%), percentage of monocytes (MOM%), percentage of eosinophils (EOS%), and percentage of basophils (BAS%).
Figure 5
Figure 5
Comparison of the ROC curves for distinguishing scabies from dermatophytosis and urticaria. (A) Eosinophil parameters included the eosinophils to lymphocyte rate (ELR), eosinophil count (EOS), and percentage of eosinophils (EOS%). (B) Monocyte parameters included monocyte-related parameters, including the MLR (monocyte to lymphocyte rate), monocyte count (MON), and percentage of monocytes (MON%).
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