Abstract

INTRODUCTION: This meta-analysis was conducted in order to evaluate the efficacy of current diagnostic measures for scabies infections. Scabies is most commonly diagnosed through clinical presentations, however, due to the wide array of symptoms, diagnosing is difficult. Most commonly used tests are the skin scraping. The challenge is that the test relies on correctly choosing the site of mite infection for visualization. Due to the nature of a live parasitic infection, however, the mite is mobile and can often be missed based on its current location within the skin. Due to the heavy reliance on clinically diagnosing, the goal of this paper is to determine a gold standard confirmatory test from microscope, dermatoscopy, PCR, ELISA, and epiluminescence.

METHODS: A literature review was conducted using the Medline, Pubmed, and Neglected Tropical Diseases databases. Eligible papers were those published after the year 2000 to present, published in English, and focusing on the diagnosis of scabies.

RESULTS: Currently, the diagnosis of scabies is mostly made via a correlation of clinical symptoms in conjunction with other techniques such as dermatoscopy (Sensitivity: 43.47%, Specificity: 84.41%) skin biopsies (Sensitivity: 43.47%, Specificity: 100%), adhesive tape tests (Sensitivity: 69.56%, Specificity: 100%) and PCR antigen detection (37.9% sensitivity, Specificity: 100%).

CONCLUSION: The overall efficacies of the diagnostic modalities differ based on the similarity of scabies to other skin conditions, the difficulty to obtain a viable sample, and the cost and availability of necessary equipment. There is a need for national guidelines to be developed in the United States.