To the Editor.—
Two of the most recent dermatologic publications on scabies recommend that specimens which are to be examined microscopically to confirm the diagnosis should be treated with potassium hydroxide solution in the same manner as is usual for fungi (Bull Military Derm18:17, 1970; Arch Derm103:168, 1971). I was surprised to discover that several current dermatologic textbooks also favor that method.1-3I am sure that this treatment with strong alkali is not only unnecessary, but has two detrimental effects which make its use inadvisable. The adult female Acarus, the nymphs, eggs, and eggshells are so large as to be easily visible microscopically without the degree of "clearing" necessary to allow fungal hyphae to be seen, which is the only reason for the use of potassium hydroxide and heating.The alkali immediately kills the adult and larval organisms, stopping their movements which have often led
Wilson JW. SCABIES. Arch Dermatol. 1971;104(2):223. doi:10.1001/archderm.1971.04000200111028
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