Tuesday, March 13, 2012

Scabies Mite

Not much to say about this little guy, except this: the way to actually get a good scabies prep is to scrape, on average, 25 lesions that look like burrows or inflamed papules.  Use a microscope slide, a 15 blade and a source of light mineral oil or microscope oil, and dip the scalpel blade in the oil, then scrape a few lesions, then wipe the blade on the slide, ensuring that you get enough debris, then repeat.  

You should be scraping deep enough to slightly abrade the papillary dermis, so you should occasionally get blood.  Pay attention to the areas like the interdigital region, wrists, areolae and also the itchiest part of the patient's body.  Those round objects floating in the oil are not scyballa or eggs, but are bubbles in the oil.  

Those oval objects above ARE scabies eggs, and are pretty easily identified as such.  
Both of these pictures were taken with my iPhone through the microscope eyepiece.

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