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Siddig EE, Hay R. Laboratory-based diagnosis of scabies: a review of the current status. Trans R Soc Trop Med Hyg 2021; 116:4-9. [PMID: 33763705 PMCID: PMC8776561 DOI: 10.1093/trstmh/trab049] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 02/28/2021] [Indexed: 02/05/2023] Open
Abstract
Scabies is a neglected tropical disease (NTD) of the skin that is caused by the mite Sarcoptes scabiei. It is considered to be an important public health problem in many regions. The disease is at its most prevalent in low-resource countries where there are overcrowded living conditions coupled with poor hygiene. In some regions, mass drug administration using ivermectin is a key population-based approach to the control of scabies. Before starting a patient on specific treatment, confirming the diagnosis by accurate and rapid identification of the organism is critical. Different laboratory-based techniques for scabies have been developed in the last few decades. These include direct microscopy and histopathology. More recently, serological testing, dermoscopy and different molecular techniques have been developed as diagnostic methods for scabies. To date, none of these, apart from microscopy and dermoscopy, has been translated into routine clinical laboratory practice. A simple point-of-care or laboratory test would provide a rapid and confirmed diagnosis and early institution of effective treatment. In this review we present an update on the laboratory techniques currently in use for the identification of scabies.
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Affiliation(s)
- Emmanuel Edwar Siddig
- Nile University, Faculty of Medicine, Khartoum, Sudan.,Erasmus Medical Center, University Medical Center Rotterdam, Department of Medical Microbiology and Infectious Diseases, Wytemaweg 80 3015 CN, Rotterdam, The Netherlands
| | - Roderick Hay
- Kings College London, Guys Campus, London SE1 9RT,UK
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Cardoso JC, Veraitch O, Gianotti R, Ferrara G, Tomasini CF, Singh M, Zalaudek I, Stefanato CM. 'Hints' in the horn: diagnostic clues in the stratum corneum. J Cutan Pathol 2017; 44:256-278. [PMID: 27717008 DOI: 10.1111/cup.12839] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2016] [Revised: 10/03/2016] [Accepted: 10/03/2016] [Indexed: 02/06/2023]
Abstract
The stratum corneum or horny layer is the uppermost layer of the epidermis, and is mainly responsible for the skin's barrier function. In spite of its complexity at the ultrastructural and molecular level, the features accessible to visualization on conventional histology are relatively limited. Nevertheless, knowledge of subtle clues that one may observe in the stratum corneum can prove useful in a wide range of situations in dermatopathology. We herein review a selection of common and rare entities in which the horny layer may reveal significantly important hints for the diagnosis. These clues include parakeratosis and its different patterns (focal, confluent, alternating, associated with spongiosis, epidermal hyperplasia or lichenoid changes), subcorneal acantholysis, infectious organisms in the stratum corneum (including fungal, bacterial and parasitic), thickening or thinning of the stratum corneum and the presence of different kinds of pigment. Even when normal, the horny layer may prove to be useful when seen in association with severe epidermal damage, a combination of features testifying to the acute nature of the underlying pathological process.
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Affiliation(s)
- José Carlos Cardoso
- Department of Dermatopathology, St John's Institute of Dermatology, St Thomas' Hospital, London, UK.,St John's Institute of Dermatology, St Thomas' Hospital, London, UK
| | - Ophelia Veraitch
- St John's Institute of Dermatology, St Thomas' Hospital, London, UK
| | - Raffaele Gianotti
- Dermatopathology Laboratory, Department of Dermatology, Universita' degli Studi di Milano, Milano, Italy
| | - Gerardo Ferrara
- Oncology Department, Anatomic Pathology Unit, Gaetano Rummo General Hospital, Benevento, Italy
| | - Carlo F Tomasini
- Dermatopathology, University Hospital Città della Salute e della Scienza, Turin, Italy
| | - Manuraj Singh
- Manuraj Singh, Department of Dermatology, St George's University Hospital, London, UK
| | - Iris Zalaudek
- Iris Zalaudek, Division of Dermatology, Non-Melanoma Skin Cancer Unit, Medical University of Graz, Graz, Austria
| | - Catherine M Stefanato
- Department of Dermatopathology, St John's Institute of Dermatology, St Thomas' Hospital, London, UK.,St John's Institute of Dermatology, St Thomas' Hospital, London, UK
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Elwood H, Berry RS, Gardner JM, Shalin SC. Superficial fibrin thrombi … and other findings: a review of the histopathology of human scabietic infections. J Cutan Pathol 2015; 42:346-52. [DOI: 10.1111/cup.12482] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2014] [Revised: 01/13/2015] [Accepted: 01/25/2015] [Indexed: 11/30/2022]
Affiliation(s)
- Hillary Elwood
- Department of Pathology; University of New Mexico School of Medicine; Albuquerque NM 87125 USA
- Department of Dermatology; University of New Mexico School of Medicine; Albuquerque NM 87125 USA
- Pathology Associates of Albuquerque; Albuquerque NM 87125 USA
| | - Ryan S. Berry
- Department of Pathology; University of New Mexico School of Medicine; Albuquerque NM 87125 USA
| | - Jerad M. Gardner
- Department of Pathology; University of Arkansas for Medical Sciences; Little Rock AR 72205 USA
- Department of Dermatology; University of Arkansas for Medical Sciences; Little Rock AR 72205 USA
| | - Sara C. Shalin
- Department of Pathology; University of Arkansas for Medical Sciences; Little Rock AR 72205 USA
- Department of Dermatology; University of Arkansas for Medical Sciences; Little Rock AR 72205 USA
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Fernandez-Flores A, Saeb-Lima M. Pulse granuloma of the lip: morphologic clues in its differential diagnosis. J Cutan Pathol 2014; 41:394-9. [DOI: 10.1111/cup.12287] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2013] [Revised: 10/12/2013] [Accepted: 11/17/2013] [Indexed: 11/30/2022]
Affiliation(s)
| | - Marcela Saeb-Lima
- Department of Pathology; Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, INER/CIENI, Hospital Angeles Lomas, Centro Medico ABC; Mexico City Mexico
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Short JH, Sulit DJ. Sea urchin spines in the stratum corneum: an early finding related to trauma. J Cutan Pathol 2013; 41:322-5. [DOI: 10.1111/cup.12257] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2013] [Revised: 10/01/2013] [Accepted: 10/10/2013] [Indexed: 01/22/2023]
Affiliation(s)
- Jack H. Short
- Department of Dermatology; George Washington University; Washington, DC 20037 USA,
| | - Daryl J. Sulit
- Dermatology Service; Walter Reed National Military Medical Center; Bethesda MD 20889 USA
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