Reflectance confocal microscopy for quantification of Sarcoptes scabiei in Norwegian scabies

Background and Objectives In vivo reflectance‐mode confocal microscopy (RCM) can be used for the diagnosis of scabies. This study quantifies S. scabiei and its eggs and droppings in a patient affected by Norwegian Scabies (NS), and describes their distribution within the epidermis and in different body areas. Methods Different skin sites were randomly chosen in four sections (head, upper limbs, trunk and inferior limbs) of the body surface area (BSA) to acquire a total of 60 RCM z‐stacks. The number of mites and eggs, the presence of droppings, as well as the minimum epidermal depth at which mites, eggs and faeces were detectable, was established for each z‐stack. The total number of mites and eggs on the entire BSA was calculated considering the weighted mean for the four sections of the BSA. Results A total of 15.8 millions of S. scabiei and 7.2 millions of eggs were calculated. Mites, eggs and faeces were homogeneously distributed all over the body surface. Droppings, easily recognized by the RCM, were present in more than an half of the analyzed cutaneous sites and were associated with the presence of parasites (chi‐squared test, P = 0.002). Conclusions Our study illustrates the ability of RCM to identify, locate, and quantify the various forms of S. scabiei in human skin. NS is an extremely contagious disease, considering that the number of mites can be around 15.8 millions. Moreover, all areas of the body are parasitized in NS, including the face.     

Ichthyosis and steroid sulfatase: study of enzymatic activity in leukocytes and fibroblasts according to the sex and type of ichthyosis

Steroidsulfatase and arylsulfatase C were determined in fibroblasts and/or leukocytes of patients affected with different types of ichthyosis. Of the 21 patients studied, 11 showed clinical characteristics of X-linked ichthyosis (XLI) and a deficiency of these 2 enzymatic activities. Patients affected with other types of ichthyosis showed no enzymatic deficiency. In XLI families diagnosis of heterozygotes was performed by enzymatic measurements in the 5 patients' mothers studied. In 2 families enzymatic activities were studied in patients' sisters. The validity of these different enzymatic measurements is discussed.     

Congenital pigmented nevus: prognosis and therapeutic possibilities]

Congenital pigmented nevi are found in approximately 1% of newborn infants. Two main factors determine their management: 1) the risk of malignancy (melanoma); 2) the aesthetic consequences, these factors being themselves dependent upon the size and the localization of the nevi. Thus, if the systematic resection of small nevi is not required, early treatment of giant nevi which carry a high risk of malignancy before the age of ten years, is highly recommended. Main methods of treatment are surgical resection (with the help of skin grafts, or cutaneous expansion or mobilization, in giant nevi), dermabrasion and curettage.