Scabies: Examination

A comprehensive clinical examination is the basis for selecting further diagnostic steps:

• General physical examination – including blood pressure, pulse, body weight, height; further:
  • Inspection (viewing) of the skin, mucous membranes, and sclerae (white part of the eye) [Leading symptoms:
    • Pruritus (itching) that increases with warmth, especially bed warmth.
    • Small, irregularly tortuous mite ducts (duct-like, elongated papules) surrounded by vesicles and eczema; predilection sites (preferentially affected areas of skin) of mite ducts include:
      • Axilla (armpit)
      • Areola (areola)
      • Inner foot edges
      • Interdigital folds (interfinger folds) of the hands / feet.
      • Knuckles
      • Navel
      • Penis
      • Perianal region (region around the anus).
      • In young children, the hairy head or face may also be affected].
• Dermatological examination – including dermoscopy (reflected light microscopy) with biopsy (tissue sampling) if necessary [due todifferential diagnoses:
  • Atopic eczema (neurodermatitis).
  • Pruriginous eczema (severely itchy skin lesions).
  • Pyoderma (pustular rash; burning, purulent inflammation of the skin).
  • Scabies incognito (larvated scabies) – in this form of scabies, the skin symptoms are absent.
  • Scabies norvegica (bark scabies) – severe form of progression of scabies, which may occur in immunocompromised individuals.
  • Animal mite dermatitis (inflammation of the skin caused by animal mites)]

  [due topossible secondary diseases:

  • Eczematous skin lesions may result from scratching.
  • Reinfection with scabies]

Square brackets [ ] indicate possible pathological (pathological) physical findings.