Scabies outbreaks in care homes for the elderly

Dermatoscopy is a convenient tool for screening large areas to find the mite; it has a very high specificity and sensitivity compared with microscopy for diagnosing common scabies and, in case of doubt, it helps to localise where to sample scrapings for microscopic examination.2 In crusted scabies, dermatoscopy as well as microscopy, allows an immediate diagnosis through the recognition of countless mites. [...]a very crucial question raised by this study is whether an outbreak of scabies in a care home for elderly people requires mass treatments for any probable or possible scabies patient, or targeted treatments only for unequivocal cases of scabies. Reporting that kind of assessment will help in detecting biases, and assess external validity, especially if mass treatment strategies are compared with diagnosis-dependent targeted treatment strategies.