Diagnosis ...

Scabies is frequently misdiagnosed as intense itching of healthy skin before the rash appears. A correct diagnosis is essential to establish appropriate treatments for scabies.

What does scabies look like?

Upon initial itching the burrows appear as small, barely noticeable bumps on the hands and may be slightly shiny and dark in color rather than red. Initially you may not actually feel the itch in the places that you have the bumps. As the infestation progresses, these bumps become more red in color.

Generally diagnosis is made by finding burrows, which often may be difficult because they are scarce, because they are obscured by scratch marks, or by secondary dermatitis (unrelated skin irritation). If burrows are not found in the primary areas known to be affected, the entire skin surface of the body should be examined.

The suspicious area can be rubbed with ink from a fountain pen or alternately a topical tetracycline solution which will glow under a special light. The surface is then wiped off with an alcohol pad; if the person is infected with scabies, the characteristic zigzag or S pattern of the burrow across the skin will appear.

Skin examination

When a suspected burrow is found, diagnosis may be confirmed by looking at skin samples under a microscope, which are placed on a slide in glycerol, mineral oil or immersion in oil and covered with a coverslip. Positive diagnosis is made when the mite, egg or droppings are found.