Definitive testing largely depends on the identification of eggs, mites, mite pellets or eggshell fragments. The advanced forms of testing involve placing a drop of mineral oil on the affected area. For the most part, doctors would identify the burrows and then place this oil on it. Once the oil is placed, the top layer of the skin is scraped laterally and longitudinally across the skin using a scalpel blade. There is minimal or no bleeding involved in the process. While scrapping 15 or more burrows, you would find one or two mites or their eggs. However in the case of crusted scabies, you would find many more mites present.

The scraped sample is then placed on the microscope slide and studied under high or low power. The use of potassium hydroxide should be avoided since it could possibly dissolve the mite pellets. In case if you do not find mites in the burrowed sample, it does not mean that you are free from scabies. We have mentioned a few tips to localise the burrow.

For an instance, if you wish to reveal the burrows, you could apply topical tetracycline on the surface of skin and then wash off the excess. The burrows would retain the tetracycline and appear fluorescent under the wooden lamp. This would simplify the identification better. Across the suspected site, you can also rub a washable felt-tip marker and then remove the ink with the help of alcohol. As soon as the burrow is found, the ink would penetrate within the stratum corneum and delineate the site.

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