Scabies mount
In instances where the physician is going to make an institution-wide recommendation with major ramifications, it is wise to positively identify the mite. A scabies mount performed at the location of the triangular dot will readily provide a mite for identification. Scabies mounts are prepared via a very superficial shave technique without anesthesia. The skin flakes are transferred to a slide and a drop of mineral oil is added. Alternatively, a drop of mineral oil can be placed on the skin and a superficial sample obtained.
Note that this technique differs from that of potassium hydroxide (KOH) preparation for fungal identification. The scabies mount technique is more like a superficial shave biopsy (with the knife blade parallel to the skin) than a KOH preparation (blade dragged along the skin surface more perpendicular to the skin).Microscopic examination of each slide reveals a mite (FIGURES 4 AND 5).
In our patient, 3 burrows were identified with a hand lens and confirmed by dermoscopy. In 2 burrows, the triangular dots were transferred to slides by doing a very superficial shave (without anesthesia) of the stratum corneum with a number 15 blade and handle. The material was placed on a slide, a drop of mineral oil added, and the slide examined microscopically (FIGURES 4 AND 5). These dermoscopically guided preparations each yielded a mite and little other debris.
FIGURE 4
Scabies mite
FIGURE 5
Mite, ova, and feces
