Malyarchuk A.P., Sokolova T.V.
The efficacy evaluation of scabies laboratory diagnosing in the Russian Federation
The research is based on the results of the study of the section «Laboratory diagnosis of scabies» of the order №162 dated 24.04.2003 «On approval of industry standard «Treatment Protocol. Scabies». The study was conducted by anonymous survey of dermatovenerologists using copyright version of the questionnaire. 319 dermatovenerologists from 50 cities and six federal districts of the Russian Federation participated in it. On assessing the results of dermatoscopy long experience of the authors’ work with patients suffering from scabies was used. The quality of laboratory diagnosis of scabies in Russia does not meet the requirements of the Russian Ministry of Health. On the whole it is used by 83,1% of doctors, constantly by 57,8% of them and only 29,5% always confirm the clinical diagnosis laboratorially. Priority methods of laboratory diagnosis of scabies are scraping with the use of an alkali (56,6%) and mite extraction with a needle (31,7%). Laboratory diagnosis in 3/4 of cases is performed with the participation of a doctor and a laboratory assistant, the diagnosis being confirmed in 63,2% of cases. Only 38,2% of dermatologists use dermatoscopy. The reasons for its rare use are: absence of dermatoscopes (69%), inability to work with them (10,2%) and ignoration of this method by physicians (20,8%). Dermatoscopy method helps to detect by 27% more scabious passages than during the inspection without the use of optical devices. The frequency of scabies mites detection in intact scabious passages (97%), follicular papules (21%) and vesicles (32%) is multivalued. Dermatoscopy detects more scabious passages, related to vesicles (by 36,4%) and pustules (by 66,1%). The effectiveness of dermatoscopy in different variants of scabies: typical, complicated, Norwegian and without passages has been shown.
Key words: multicenter research, scabies, laboratory diagnosing, efficacy, dermatoscopy.