Provider performed microscopy- mineral oil immersion
Performed by authorized providers in the point of care. Clinical identification of scabies mites, eggs or fecal pellets is necessary to confirm scabies infestation. This is best accomplish with mineral oil preparation which will not dissolve fecal pellets as opposed to KOH examination. This procedure is performed by Dermatologists.
•Use of a contaminated reagent can cause false positive exam.
•The ability to get a positive result is very dependent on location from which scraping is acquired.
1. Prior to collecting specimen, perform hand hygiene and put on gloves and other PPE needed. Follow standard precautions when collecting, handling and disposing of specimens.
2.Primary lesions are typically located in the finger webs, on the flexor surfaces of the wrists, on the elbows, in the axillae, on the buttocks and genitalia, and on the breast. The best place to find a scabies burrow is on the medial aspect of the hypothenar area of the hands and wrists. Note: Samples should be taken from the unexcoriated burrows or intact papules.
3.Using a #15 scalpel blade. Dip the blade in the mineral oil and scrape the burrows. The mite lives in the stratum corneum, so will not need to draw a lot of blood. A small amount of bleeding may occur, but should not interfere with examination.
4.Apply gathered specimen to glass slide.
For more test specific information, please refer to the test procedure found on the Michigan Medicine POC website: https://www.pathology.med.umich.edu/point-of-care.