High-magnification videodermatoscopy: a new noninvasive diagnostic tool for scabies in children.

A study of 100 children suspected of having scabies was carried out using high-magnification (HM) videodermatoscopy as the only diagnostic tool. HM videodermatoscopy reaches magnifications of up to 600x and allows a detailed inspection of the skin. Rapid and clear identification of mites, migration burrows, eggs, and feces was obtained in 62 of 100 patients. None of the 38 patients with negative findings showed any sign of infestation 2 weeks later. HM videodermatoscopy is rapid, effective, and sensitive, especially in those cases with nonspecific clinical features, and allows clear detection of diagnostic details usually not appreciable at lower magnifications. It has high specificity, with no chance of false-positive results, and being noninvasive, it eliminates the risk of accidental infections. Finally, the most important advantage in children is its high compliance rate, as it does not cause pain or physical or psychological discomfort. It may be used for primary diagnosis as well as for posttherapeutic follow-up and for screening of family members, thus reducing the risk of persistence and diffusion of the infestation.