The currently available diagnostic tools and treatments of scabies and scabies variants: An updated narrative review

Abstract

Scabies is a neglected tropical disease that continues to have global impacts and long-term health consequences. It is caused by the mite Sarcoptes scabei var. hominis, which is an obligate ectoparasite that lives in the epidermis of the human skin. Scabies is common in poor communities due to overcrowding in places like old age homes, prisons, and homeless and displaced children. However, developed countries are also susceptible to scabies infestations, such as in institutional outbreaks or small epidemics under war conditions or during natural disasters. The diagnosis of scabies may be assisted by invasive and noninvasive tools; However, the history and examination findings are usually adequate to confirm the clinical suspicion. Here, we present an updated review of scabies by focusing on the diagnostic approaches, treatment, and prevention of scabies.

The differential diagnoses and complications of scabies variants

“…However, darker skin phototypes, hairy areas, and complications caused by scratching (such as excoriations, crusts, bleeding, or microscopic dirt particles) make it difficult to identify the scabies mite with dermoscopy 1 . In crusted scabies, dermoscopy shows multiple burrows and a hyperkeratotic appearance 1 . Anyhow, the main limitation of dermoscopy is low specificity because of lower magnification 10 .…”

“…Videodermoscopy is a quick, non-invasive diagnostic method with 100% specificity and greater sensitivity than skin scraping 1,10 . Since it does not make the patient uncomfortable, it can be used in patients who are non-cooperative 10 .…”

“…Through RCM, the burrows can be seen as linear segments in the middle of the surrounding epidermis that appear as a "honeycomb" pattern 1,10 . In addition, eggs, feces, larvae, and mites can be seen 10 .…”

“…Scabies is a neglected tropical cutaneous disease that affects people of all ages 1 . Children, adolescents, and elderly individuals are the most frequently affected age groups with no gender predilection 2,3 .…”

“…Poor hygiene, poverty, homelessness, overcrowding, lack of access to medical care, immunodeficiency, indiscriminate sexual activity, and demographic forces (including wars and migration) are significant risk factors for scabies infection 2,5,6 . Several family members may be infested at the same time, as scabies mites are transmitted by direct and indirect transmission 1 .…”