A Case Report of Real-Time in vivo Demonstration of Sarcoptes scabiei

Scabies is a pruritic dermatosis caused by the ectoparasite Sarcoptes scabiei var. hominis. The diagnosis of scabies is usually made on clinical grounds, but histopathological and/or dermoscopic examinations may sometimes be of assistance. However, these diagnostic modalities do not offer a detailed in vivo demonstration of the motile microorganism. Reflectance confocal microscopy (RCM) is a relatively novel imaging modality that permits in vivo examination of the skin at a resolution similar to that used during similar to histopathologic resolution. Here, a patient with crusted scabies is presented in whom a brief section of the lifecycle of S. scabiei was captured by RCM. Using this advanced imaging modality, the ectoparasite's motion within the human host can be examined for clinical or research purposes and the mite's viability may be assessed to monitor the response to treatment.