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

皮肤镜检查、光学显微镜检查和实时聚合酶链反应用于诊断疥疮。初步结果

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作者:Aleksandra Kosmala, Michał J Kowalczyk, Ryszard Żaba

Aim

To compare diagnostic

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.

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

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

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.

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