In conclusion, combination peels achieved a higher and earlier therapeutic response with a reasonable cost that is maintained for a relatively long periods than single peel. Combination sequential peels gave the best results.

Background: Epidermal parasitic skin diseases (EPSD) are a diverse group of neglected parasitic diseases that affect the outermost layer of skin. Diagnosing Scabies, Pediculosis, and Leishmaniasis is a problematic issue. Dermoscopy is regarded in vivo as a highly sensitive and efficient diagnostic approach for EPSD. Objective: The current study aimed to assess and describe typical dermoscopic characteristics utilized for diagnosis of the most prevalent parasite skin disorders in Egypt, including Scabies, Pediculosis, and Leishmaniasis. Patients and methods: The present study included 110 EPSD patients, especially Scabies, Pediculosis, and cutaneous leishmaniasis. All patients underwent a comprehensive history, physical, dermatological examination, and photography of suspicious lesions. Dermoscopes investigated these lesions. Results: Of the included 110 patients, 50 had scabies, 50 had pediculosis, and 10 had cutaneous leishmaniasis. Dermoscopy of 50 scabies patients revealed a darkening triangle in 84% and a burrow in 86%. Among 50 pediculosis patients, 72% exhibited ovoid brownish nits with a nymph, 52% had empty nits, and approximately 16% had both empty and full nits, while 16% had mobile lice. Phthirius crab louse was only identified in 2% of patients. Leishmania dermoscopy exhibited widespread erythema throughout all lesions, hyperkeratosis in eight cases, and central erosion/ulceration in eight cases. Conclusion:Conventional dermoscopy with a handheld Dermatoscope is an effective method for diagnosing scabies, pediculosis, and cutaneous leishmaniosis with a high degree of sensitivity. It significantly improves clinical decisionmaking and diagnosing skills.

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