eISSN: 2299-0046
ISSN: 1642-395X
Advances in Dermatology and Allergology/Postępy Dermatologii i Alergologii
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SCImago Journal & Country Rank
4/2021
vol. 38
 
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abstract:
Original paper

Dermoscopy, light microscopy, and real-time polymerase chain reaction for the diagnosis of scabies. Preliminary results

Aleksandra Kosmala
1
,
Michał J. Kowalczyk
1
,
Ryszard Żaba
1

1.
Department of Dermatology and Venereology, Poznan University of Medical Sciences, Poznan, Poland
Adv Dermatol Allergol 2021; XXXVIII (4): 578–584
Online publish date: 2020/04/07
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Introduction
Scabies is a widespread, contagious parasitic disease causing intense itching. Its detection is a significant problem while there are no internationally agreed standards.

Aim
To compare diagnostic methods: microscopy of skin scrapings, dermoscopy, and real-time polymerase chain reaction (PCR) of skin scrapings and wet skin swabs.

Material and methods
We included patients with clinical signs of scabies. After dermoscopic evaluation, scrapings were collected from skin lesions and assessed by light microscopy and real-time PCR. Wet skin swabs were also analysed by real-time PCR. Surveys on the presence and severity of pruritus and skin lesions were collected. Seventy-five skin scrapings and 41 wet swabs were examined by real-time PCR. Fifty-three patients completed the survey. All patients underwent dermoscopy and microscopy examinations. 6.67% were positive by microscopy, 10.7% by dermoscopy, 28.0% by real-time PCR from scrapings, and 36.6% when both scrapings and swabs were examined by real-time PCR. All microscopy-positive results were also positive by PCR.

Results
There was a correlation between real-time PCR from positive scrapings and pruritus (p = 0.023) and body surface area of lesions (p = 0.002), a correlation between copies from wet skin swabs and BSA of lesions (p = 0.002) in the whole group, and a correlation between copies of S. scabiei from scrapings and age (p = 0.038).

Conclusions
Real-time PCR testing of scrapings and dermoscopy are more effective than microscopy. Combined real-time PCR testing of scrapings and skin swabs seemed the most effective. Clinical signs alone should not be used as unambiguous criteria.

keywords:

scabies, itch, dermoscopy, real-time chain reaction

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