Diagnosis and treatment response monitoring of scabies with reflectance confocal microscopy: A diagnostic pearl

[1] However, its specificity is lower (46%) because it does not allow visualization of eggs and feces. [...]the so-called “delta wing jet” sign can be difficult to differentiate from artefacts induced by scratching and bleeding and is hardly visible on dark skin or in hairy body areas, making diagnosis difficult. Solution To perform reflectance confocal microscopy (RCM) forin vivo examination of a skin lesion clinically and/or dermoscopically compatible with a S. scabiei burrow [Figure 1]a, [Figure 1]b, [Figure 1]c, [Figure 1]d.{Figure 1} RCM is a noninvasive imaging technique which allows real-time visualization of cellular components in the skin, providing serial transverse cuts at different depths. [...]lack of movement of the mite in ex vivo light microscopy observation is not a reliable indicator of scabicide efficacy, as it can be due to traumatic injury to the parasite during the scraping procedure.