Parasitosis

From dermoscopedia

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 Authored by: Aimilios Lallas

 Keywords:   parasitosis · scabies · tungiasis · larva migrans · pediculosis · tick bites
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Description DermoscopyDermoscopy is a non invasive diagnostic method. of parasitosisThis glossary term has not yet been described.
Author(s) Aimilios Lallas
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Status update September 12, 2017
Status by Ralph P. Braun
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ScabiesThis glossary term has not yet been described.

The typical dermoscopic pattern of scabiesThis glossary term has not yet been described. consists of small dark brown triangular structures located at the end of whitish structureless lines (curved or wavy), giving an appearance reminiscent of a delta-wing jet with contrail (Fig 9a).[1] Microscopically, the brown triangle corresponds to the pigmented anterior part of the mite, while the burrow of the mite correlates dermoscopically to the contrail feature. Since then, the value of dermoscopyDermoscopy is a non invasive diagnostic method. in diagnosisThis glossary term has not yet been described. of scabies has been extensively investigated in several studies.[2][3][4][5] The diagnostic accuracy of the technique was reported to be at least equal to traditional ex-vivo microscopic examination (i.e. skin scraping), while additional comparative advantages of dermoscopy include its non-invasiveness and lower requirements in terms of time, costs and experience.[4][5] Nowadays, dermoscopy has replaced ex-vivo microscopy as the routine method for diagnosis of scabies in several dermatology centers. Additional to its value for diagnosis, dermoscopy may also be useful in treatment monitoring, heralding treatment success when dermoscopic ‘jet with contrail’ features can no longer been detected.[6]

TungiasisThis glossary term has not yet been described.

Tungiasis is a skin infestation caused by the sand flea Tunga penetrans and is mainly endemic in the tropical regions of South and Central America, Africa, Asia and the Caribbean Islands. Because of its low incidence outside endemic areas, its clinical features are less recognized and diagnosis may be delayed. Dermoscopy of the disease typically reveals a white to flesh colored to light brown nodule with a central targetoid brownish ring, which in turn surrounds a central (often blackish) pore.[7][8]

Cutaneous larva migransThis glossary term has not yet been described.

Dermoscopy has been shown to facilitate the clinical recognition of larva migransThis glossary term has not yet been described. (creeping eruption), by revealing translucent brownish structureless areas in a segmental arrangementThis glossary term has not yet been described., corresponding to the body of the larva.[9]

PediculosisThis glossary term has not yet been described.

Dermoscopy allows a rapid and reliable diagnosis of pediculosisThis glossary term has not yet been described. by revealing the lice itself or the nits fixed to the hair shaft (Fig 9b).[10][11]Nits containing vital nymphs dermoscopically display ovoid brown structures, while the empty nits are translucent and typically show a plane and fissured free ending. This information is particularly useful for treatment monitoring, since dermoscopic detection of vital nits should lead to a continuation or modification of therapy. Additionally, dermoscopy has been recently shown to enable the discrimination between nits and the so-called pseudo-nits, such as hair casts, debris of hair spray or gel. The latter are not firmly attached to the hair shaft and appear dermoscopically as amorphous, whitish structures.[12]

Tick bitesThis glossary term has not yet been described.

Dermoscopy has been reported to highlight the presence of tick infestation by enabling the visualization of their anterior legs protruding from the surface of the skinThis glossary term has not yet been described., while a brown to grey translucent ‘shield’ with pigmented streakslines, radial (always at periphery) Reed nevus, melanoma, recurrent nevus corresponds to the tick’s body (Fig 9d). Following the removal of the tick, detection of brown to black to grey areas of pigmentation by dermoscopy indicates incomplete removal.[13][14]
  1. Argenziano et al.: Epiluminescence microscopy. A new approach to in vivo detection of Sarcoptes scabiei. Arch Dermatol 1997;133:751-3. PMID: 9197830.
  2. Bauer et al.: Nodular scabies detected by computed dermatoscopy. Dermatology (Basel) 2001;203:190-1. PMID: 11586026.
  3. Prins et al.: Dermoscopy for the in vivo detection of sarcoptes scabiei. Dermatology (Basel) 2004;208:241-3. PMID: 15118379. DOI.
  4. 4.0 4.1 Walter et al.: Comparison of dermoscopy, skin scraping, and the adhesive tape test for the diagnosis of scabies in a resource-poor setting. Arch Dermatol 2011;147:468-73. PMID: 21482897. DOI.
  5. 5.0 5.1 Park et al.: The diagnostic accuracy of dermoscopy for scabies. Ann Dermatol 2012;24:194-9. PMID: 22577271. DOI.
  6. Hamm et al.: Treatment of scabies with 5% permethrin cream: results of a German multicenter study. J Dtsch Dermatol Ges 2006;4:407-13. PMID: 16686608. DOI.
  7. Bauer et al.: Dermoscopy of tungiasis. Arch Dermatol 2004;140:761-3. PMID: 15210479. DOI.
  8. Bauer et al.: Variability of dermoscopic features of tungiasis. Arch Dermatol 2005;141:643-4. PMID: 15897397. DOI.
  9. Veraldi et al.: Epiluminescence microscopy in cutaneous larva migrans. Acta Derm. Venereol. 2000;80:233. PMID: 10954233.
  10. Micali et al.: Dermatoscopy: alternative uses in daily clinical practice. J. Am. Acad. Dermatol. 2011;64:1135-46. PMID: 21292346. DOI.
  11. Di Stefani et al.: Dermoscopy for diagnosis and treatment monitoring of pediculosis capitis. J. Am. Acad. Dermatol. 2006;54:909-11. PMID: 16635683. DOI.
  12. Zalaudek & Argenziano: Images in clinical medicine. Dermoscopy of nits and pseudonits. N. Engl. J. Med. 2012;367:1741. PMID: 23113485. DOI.
  13. Oiso et al.: Diagnostic effectiveness of dermoscopy for tick bite. J Eur Acad Dermatol Venereol 2010;24:231-2. PMID: 19686261. DOI.
  14. Matsuda et al.: Dermoscopy for tick bite: reconfirmation of the usefulness for the initial diagnosis. Case Rep Dermatol 2011;3:94-7. PMID: 21577370. DOI.