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Home Books The Atlas of Emergency Medicine, 5e

25-08: Skin Scraping for Dermatoses and Infestations

Camiron L. Pfennig; B. Ethan Brown

Uses

To determine fungal dermatoses or skin infestations.

Materials

Fresh skin scraping, glass microscope slide, coverslip, 10% potassium hydroxide or mineral oil.

Method

  1. Specimen collection:

    1. Gently scrape skin lesion with edge of a number 15 scalpel.

  2. Slide preparation:

    1. Pediculosis may be seen grossly clinging to individual hairs or under low power. Live nits may fluoresce with a Wood lamp.

    2. For scabies, place a drop of KOH or mineral oil onto the slide.

    3. Suspend a small amount of the scraping onto the drop.

    4. Overlay a coverslip.

    5. Let sit at room temperature for 30 minutes; as an alternative, gently heat the slide over a Bunsen burner but do not boil.

    6. Examine under microscope for hyphae, spores, or infestations.

FIGURE 25.21

Scabies. Skin scraping from a patient with scabies. Note the intact mite at the lower right of the photograph, and the ova and fecal pellets. (Photo contributor: Department of Dermatology, Naval Medical Center, Portsmouth, VA.)

A slide under the microscope shows a row of oval structures and a scattering of small, dark dots.
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A slide under the microscope shows a row of oval structures and a scattering of small, dark dots.
FIGURE 25.22

Scabies. Adult female scabies mite. (Reproduced, with permission, from Morse SA, Ballard RC, Holmes KK, Moreland AA (eds). Atlas of Sexually Transmitted Diseases and AIDS. 3rd ed. Philadelphia, PA: Mosby; 2003. Copyright © 2003 Elsevier.)

A slide under the microscope shows an oval organism with small legs at the front and back.
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A slide under the microscope shows an oval organism with small legs at the front and back.
Vedio Graphic Jump Location
Video 25-03: Norwegian Scabies

Skin scrapig from a patient with Norwegian scabies. Three active mites are seen.
image
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FIGURE 25.23

Pediculosis. Phthirus pubis, the crab louse. Note the short body and claw-like legs, which are ideally suited for clinging to the hair shaft. (Photo contributor: Department of Dermatology, Naval Medical Center, Portsmouth, VA.)

A slide under the microscope shows an organism with three pairs of legs and a pair of antenna. Two legs on one side of the organism hold onto a strand of hair.
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A slide under the microscope shows an organism with three pairs of legs and a pair of antenna. Two legs on one side of the organism hold onto a strand of hair.
FIGURE 25.24

Pediculosis. Phthirus corporis, the body louse. Note the elongated body. (Photo contributor: Department of Dermatology, Naval Medical Center, Portsmouth, VA.)

An image shows many small brown insects with elongated bodies, three pairs of legs, and a pair of antenna.
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An image shows many small brown insects with elongated bodies, three pairs of legs, and a pair of antenna.

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