Frequency of Burrows Under Dermatoscope in Children Suspected of Scabies Presenting at Tertiary Care Hospital Karachi

Frequency of Burrows Under Dermatoscope in Children Suspected of Scabies

Abstract

Scabies is a highly contagious parasitic skin condition that is more common among children in resource-poor environments. The diagnosis is difficult to make due to atypical presentations in the paediatric age group. Dermoscopy is a non-invasive tool that can be used in real time to visualise-scabies-specific structures such as burrows. Objectives: To assess the diagnostic yield of dermoscopy in detecting scabies burrows in children with clinically suspected scabies. Methods: An analytical cross-sectional study was conducted at the Department of Dermatology, Civil Hospital, Karachi, from March to June 2025 (Approval No.: IRB-3811/DUHS/Approval/2025/105). Seventy-one children aged 1–16 years with clinical suspicion of scabies were enrolled by non-probability consecutive sampling. A polarised handheld dermoscope (10× magnification) with ultrasound gel as the interface medium was used. A binary logistic regression was used, and p<0.05 was regarded as statistically significant. Results: The mean age was 7.1 ± 4.3 years; 46 (64.8%) were female. The use of dermoscopy revealed that 36 (50.7%) children had burrows. Statistically significant associations were observed with longer symptom duration (OR = 0.80; 95% CI: 0.648–0.986; p=0.026) and prior scabies treatment (OR = 3.61; 95% CI: 1.324–9.849; p=0.011). Conclusions: The diagnostic yield of dermoscopy in children with clinical suspicion of scabies was around 50%, which was lower than previously reported. The presence of burrows was more likely when symptoms had been present longer and if treatment had been given.