Adult mite with fecal pellet visible posteriorly (at right). as a thin (0.3 to 0.5 mm), grayish-white, elevated, serpiginous track 1 to 10 mm long. The remaining papular, vesicular, excoriated, and secondarily infected lesions are not specific.
To confirm the diagnosis, place a drop of immersion oil on a #15 blade and scrape a burrow, preferably until fine specks of blood are noted. Place the specimen on a slide and examine under low power (4× objective). In the majority of cases (but not all), a mite, an ovum, or fecal pellets should be demonstrable. An adult mite and a fecal pellet can be seen in the Figure; an ovum is egg-shaped and approximately 20% to 25% of the size of an adult mite. Lesions other than burrows are much less likely to be "positive."
Treatment is simple and effective: apply 1% gamma benzene hexachloride (Kwell) cream or lotion from the
Parlette HL. Scabies in Man. Arch Dermatol. 1976;112(3):409-410. doi:10.1001/archderm.1976.01630270071020