Dermoscopy of Burrow Ink Test in a Case of Scabies (Dermoscopic Burrow Ink Test: D-Bit)

Bhakti Sarda, Bhushan Madke, Drishti Bhatt, Sree Ramya Talasila
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Abstract

A 14-year-old girl residing in a boarding school complained of itching over the web spaces of both hands, wrists, trunk, and ankle area for 3 weeks, which was more intense during bedtime. Many of her colleagues at the boarding school had similar complaints.

Cutaneous examination showed multiple papular eruptions and excoriation in the web spaces of both hands, wrist joint, peri-umbilical area, and ankles. A dermoscopy examination of one of the papular lesions showed a greyish-white curvilinear tract (Figure 1a). Burrow ink test (BIT) was performed by gently rubbing fountain pen ink over the papular lesion and excess ink was wiped off using an alcohol swab after 1 min, which on dermoscopy showed an ink-filled blue curvilinear tract with few filling defects (Figure 1b).

The burrow ink test is a simple, non-invasive test that can rapidly screen suspected cases [1, 2]. Performing dermoscopy after a burrow ink test over multiple lesions can increase the chance of a positive test. Literature suggests that the best place to find a burrow lesion is the medial aspect of the hypothenar area of the hands and wrists [3].

To conclude, a dermoscopy of the burrow ink test can better visualize the chances of locating a burrow.

疥疮皮肤镜下洞墨试验1例(皮肤镜下洞墨试验:d位)
一名14岁的寄宿学校女生自诉双手、手腕、躯干、脚踝等部位痒了3周,睡觉时更痒。她在寄宿学校的许多同事都有类似的抱怨。皮肤检查显示双手、腕关节、脐周和脚踝处有多发丘疹和擦伤。其中一个丘疹病变的皮肤镜检查显示一个灰白色的曲线束(图1a)。用钢笔墨水在丘疹处轻轻摩擦,1分钟后用酒精拭子擦去多余的墨水,皮肤镜下可见一个墨水填充的蓝色曲线束,填充缺陷很少(图1b)。穴墨试验是一种简单、无创的检测方法,可快速筛查疑似病例[1,2]。在对多个病变进行洞穴墨水测试后进行皮肤镜检查可以增加测试阳性的机会。文献表明,发现洞穴病变的最佳位置是手和手腕的鱼际下区域的内侧。总而言之,皮肤镜下的墨水测试可以更好地可视化定位洞穴的机会。
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