10.5826/dpc.1302a135
text/xml
2160-9381
2868
en
Cristian Navarette-Dechent
https://creativecommons.org/licenses/by-nc/4.0
Dermatology Practical & Conceptual
Scabies mite is bright green under UV dermatoscopy
Text.Serial.Journal
https://dpcj.org/index.php/dpc
Image Letter
2023-04-29
2022-09-24
2023-04-29
2023-06-05
e2023135
Dermatol Pract Concept
Cristian Navarette-Dechent
2023/04/29
10.5826/dpc.1302a135
e2023135
Department of Dermatology, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
2160-9381
en
e2023135
Engelman D, Yoshizumi J, Hay RJ, et al. The 2020 International Alliance for the Control of Scabies Consensus Criteria for the Diagnosis of Scabies. Br J Dermatol. 2020;183:808-20.
Scabies mite is bright green under UV dermatoscopy
https://dpcj.org/index.php/dpc/article/download/2868/1981
                      Scabies Mite is Bright Green Under
                              UV Dermatoscopy
                                Paweł Pietkiewicz1,2, Cristian Navarrete-Dechent3,4


1 Dermatology Private Practice, Poznań, Poland
2 Polish Dermatoscopy Group, Poznań, Poland
3 Department of Dermatology, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
4 Melanoma and Skin Cancer Unit, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile



Citation: Pietkiewicz P, Navarrete-Dechent C. Scabies Mite is Bright Green Under UV Dermatoscopy. Dermatol Pract Concept.
2023;13(2):e2023135. DOI: https://doi.org/10.5826/dpc.1302a135
Accepted: November 23, 2022; Published: April 2023
Copyright: ©2023 Pietkiewicz et al. This is an open-access article distributed under the terms of the Creative Commons Attribution-
NonCommercial License (BY-NC-4.0), https://creativecommons.org/licenses/by-nc/4.0/, which permits unrestricted noncommercial use,
distribution, and reproduction in any medium, provided the original authors and source are credited.
Funding: None.
Competing interests: None.
Authorship: All authors have contributed significantly to this publication.
Corresponding author: Paweł Pietkiewicz, Centrum Medyczne Zwierzyniecka, Zwierzyniecka Street 30/28, Poznań 60-814. Telephone: +48
602 133 503 Email: pietkiewicz.pp@gmail.com




Case Presentation                                                        blue tunnel [1], as well as a novel feature—­
                                                                                                                     bright-green
                                                                         fluorescence generated by the body of a female mite
A 38-year-old man presented with a 1-month history                       (Figure 1C).
of   multiple     itchy    erythemo-desquamative          anogeni-
tal lesions ­
            (Figure 1A). Examination with polarized
                                                                         Teaching Point
dermatoscopy revealed the typical “delta-wing jet with
a contrail sign” (brown delta/triangular structure be-                   Human scabies is a parasitic infestation caused by the mite
ing the mite’s mouth and a first pair of legs, followed by               Sarcoptes scabiei affecting more than 400 million people
the curvilinear burrow with an extending free edge) (Fig-                worldwide annually. The parasite is too small to be readily
ure 1B). UV-induced fluorescence dermatoscopy (365 nm,                   identified with the naked eye alone. Thus, a gold standard of
Dermlite) was able to reveal previously reported bright                  diagnostics includes visualization of mite, eggs or feces with




Image Letter | Dermatol Pract Concept. 2023;13(2):e2023135                                                                            1
    Figure 1. (A) Clinical image of multiple itchy erythematous genital lesions covered with delicate scale in a 38-year old man (iPhone 6
    camera). (B) Polarized dermatoscopy of one of the genital lesions showing a “delta-wing jet with a contrail sign”; a triangular struc-
    ture is better seen in the box. (Dermlite DL5 paired with iPhone 6). (C) UV dermatoscopy of the same lesion highlights the bright-blue
    fluorescence of the burrow, but also visualizes the bright-green fluorescence generated by the female mite’s body (better seen in the
    box) (Dermlite DL5 paired with iPhone 6).



light microscopy. Dermoscopy also offers a means for the vi-             References
sualization of mites as “delta sign” [2]. Dermoscopy has been
                                                                          1. Nie J, Gou T, Xu L, Wang W, Zhang L, Lu Y. Misdiagnosed
reported being as accurate as skin scraping. However, novices
                                                                             scabies correctly diagnosed by dermoscopy using ultraviolet
can often confuse the ‘delta sign’ with crusts or debris.
                                                                             light mode. Clin Exp Dermatol. 2021;46(8):1601-1603. DOI:
    The rise of UV dermatoscopy opens a new box of previ-                    10.1111/ced.14794. PMID: 34101872.
ously unobserved clues, including the observed green fluores-             2. Engelman D, Yoshizumi J, Hay RJ, et al. The 2020 International
cence of the mite’s body in the UV dermatoscopy. The novel                   Alliance for the Control of Scabies Consensus Criteria for the
diagnostic feature might be especially helpful for novices, in               Diagnosis of Scabies. Br J Dermatol. 2020;183(5):808-820.
                                                                             ­
                                                                             PMID: 32034956. PMCID: PMC7687112.
clinically non-obvious cases (adding to diagnostic accuracy),
in future AI-assisted models, or serve for a test of cure.




2                                                                               Image Letter | Dermatol Pract Concept. 2023;13(2):e2023135
