Escabiosis en lactante: diagnóstico dermatoscópico y test de Müller / Infant scabies: dermoscopic diagnosis and Müller test

RESUMEN

La escabiosis o sarna es la infestación cutánea por el ácaro Sarcoptes scabiei var. hominis, cuyo diagnóstico generalmente es clínico, pudiendo confirmarse mediante el test de Müller o, de forma sencilla y fiable, mediante estudio dermatoscópico. Se presenta un caso representativo de escabiosis en lactante y los hallazgos dermatoscópicos patognomónicos en un lactante de 6 meses de edad. Con la sospecha de escabiosis se realizó estudio con dermatoscopia de luz polarizada, confirmando el diagnóstico al visualizar surcos acarinos y lesiones en ala delta. Además, se realizó el test de Müller, observando el ácaro en el examen directo al microscopio óptico tras raspado de piel lesionada. Con este caso se pretende recordar la clínica típica con las características distintivas de la escabiosis en lactantes, y los principales métodos que permiten confirmar el diagnóstico, con especial relevancia de la dermatoscópica como técnica sencilla e inocua

ABSTRACT

Scabies, a skin infestation caused by Sarcoptes scabiei var. hominis, is generally easy to diagnose because of its characteristic clinical features. The diagnosis can be confirmed by the Müller test or by dermoscopy, a non-invasive, painless, and highly accurate technique. We present a representative case of infantile scabies with pathognomonic dermoscopic findings, in a 6-month-old girl referred for evaluation of a 2-week dermatitis. Under suspicion of scabies, a dermoscopy examination was performed, confirming the diagnosis by showing a distinctive dermoscopic feature composed of a S-shaped furrow with a triangle on one of its endings, known as delta wing jet sign. In addition, Müller test was performed, observing the mite on direct microscope examination after scraping one of the skin injuries. This case is a reminder of the typical clinical presentation of scabies in infants and the main methods that allow us to confirm the diagnosis. We want to highlight the usefulness of dermoscopy, as it is a simple and innocuous technique