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Effectiveness of Cytochrome c Oxidase Subunit 1 Gene Nested Polymerase Chain Reaction Compared to Dermoscopy or Microscopy Alone for the Detection and Diagnosis of Sarcoptes scabiei var. hominis Infection

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Background Background: While microscopy (MS) evaluation of skin scrapings has a 100% positive predictive value and specificity by definition for scabies diagnosis, it has low sensitivity. Dermoscopy (DS) has not yet been widely accepted for diagnosis, and long-term clinician training is required. Objective To evaluate the diagnostic validity of cytochrome c oxidase subunit 1 (cox1) gene nested polymerase chain reaction (PCR) as an adjunctive method for diagnosing scabies. Methods This was a prospective, single institution study, conducted on a total of 302 skin lesions from 50 patients suspected of scabies at Kangdong Sacred Heart Hospital in Seoul, Korea. DS, MS, and cox1 nested PCR were performed on all patients. Results Of the 302 lesions, 145 (48.0%) were obtained at first visit and 157 (52.0%) were identified in the course of follow-up visits after treatment. For all lesions, DS and MS sensitivity levels were 55.9% (73/136) and 55.2% (75/136), respectively, with cox1 gene nested PCR considered as 100%. The results of DS and MS identification showed no difference between each other and showed significant difference from that of cox1 gene nested PCR. Conclusion Nested PCR detecting cox1 may be prospectively used to comprehensively diagnose lesions of scabies in clinical practice.

Abstract

Background Background: While microscopy (MS) evaluation of skin scrapings has a 100% positive predictive value and specificity by definition for scabies diagnosis, it has low sensitivity. Dermoscopy (DS) has not yet been widely accepted for diagnosis, and long-term clinician training is required. Objective To evaluate the diagnostic validity of cytochrome c oxidase subunit 1 (cox1) gene nested polymerase chain reaction (PCR) as an adjunctive method for diagnosing scabies. Methods This was a prospective, single institution study, conducted on a total of 302 skin lesions from 50 patients suspected of scabies at Kangdong Sacred Heart Hospital in Seoul, Korea. DS, MS, and cox1 nested PCR were performed on all patients. Results Of the 302 lesions, 145 (48.0%) were obtained at first visit and 157 (52.0%) were identified in the course of follow-up visits after treatment. For all lesions, DS and MS sensitivity levels were 55.9% (73/136) and 55.2% (75/136), respectively, with cox1 gene nested PCR considered as 100%. The results of DS and MS identification showed no difference between each other and showed significant difference from that of cox1 gene nested PCR. Conclusion Nested PCR detecting cox1 may be prospectively used to comprehensively diagnose lesions of scabies in clinical practice.

참고문헌 (9)

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  2. Pannell RS, "The incidence of molluscum contagiosum, scabies and lichen planus", Epidemiol Infect, 133, pp.985~991 (2005)
  3. Walton SF, "Problems in diagnosing scabies, a global disease in human and animal populations", Clin Microbiol Rev, 20, pp.268~279 (2007)
  4. Prins C, "Dermoscopy for the in vivo detection of sarcoptes scabiei", Dermatology, 208, pp.241~243 (2004)
  5. Dupuy A, "Accuracy of standard dermoscopy for diagnosing scabies", J Am Acad Dermatol, 56, pp.53~62 (2007)
  6. Park SE, "Efficacy and safety of a lindane 1% treatment regimen for scabies, confirmed by dermoscopy-guided skin scraping with microscopic examination", Clin Exp Dermatol, 40, pp.611~616 (2015)
  7. Ju Hyuk Park, "The Diagnostic Accuracy of Dermoscopy for Scabies", Annals of Dermatology, 24(2), pp.194~199 (2012), 대한피부과학회[DOI]
  8. Wong SS, "Development of conventional and real-time quantitative PCR assays for diagnosis and monitoring of scabies", J Clin Microbiol, 53, pp.2095~2102 (2015)
  9. Hahm JE, "The efficacy of a nested polymerase chain reaction in detecting the cytochrome c oxidase subunit 1 gene of Sarcoptes scabiei var. hominis for diagnosing scabies", Br J Dermatol, 179, pp.889~895 (2018)

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