Sarcoptes scabiei

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Scabies may be accurately diagnosed clinically in places where it is common when diffuse itching presents along with either lesions in two typical spots or a household member is also itchy. The classical proof of scabies is the detection of burrows made by the mites in the skin. Typically, the suspected area is rubbed with ink from a fountain pen or a topical tetracycline solution, which glows under a special light. The skin is then wiped with an alcohol pad. If the person is infected with scabies, the characteristic zigzag or "S" pattern of the burrow will appear across the skin; however, this may be difficult as the burrows are scarce and may be obscured by scratch marks. A definitive diagnosis is made by finding either the scabies mites or their eggs and fecal pellets. Searches for these signs involve either scraping a suspected area, mounting the sample in potassium hydroxide, and examining it under a microscope, or using dermoscopy to examine the skin directly.


Differential diagnosis

Symptoms of early scabies infestation mirror other skin diseases, including dermatitis, syphilis, various urticaria related syndromes, allergic reactions and other ectoparasites such as lice and fleas.