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Richard Siderits, MD
Christopher Sereni, MSIII
Sujal Singh, Experimental Pathology Team

Video of Live mites under the microscope
High magnification video
This video shows the appropriate pressure to exert on skin when doing a skin scraping for scabies.

Scabies is a highly contagious parasitic infection that can cause an itchy, painful rash, in addition to severe discomfort. It spreads rapidly in crowded environments such as nursing homes, hospitals, military installations, and child-care facilities. Transporting patients to a medical facility for skin scraping increases the risk of spreading infection, increases cost of the procedure, and delays diagnosis and treatment.

A scabies skin scraping kit is useful and easy to assemble. Benefits of such a kit include timely skin sampling, followed by rapid diagnosis and prompt treatment. This saves time and expense for health care providers.

Step 1: Kit Contents

The following items are needed to assemble one scabies skin scraping kit.

Ziplock bag (1)
Gloves (2)
Pencil (1)
Webcol (1)
Tube for oil w/ cap (1)
Bandages (1)
Biohazard bag with required instructions (1)
Retractable scalpel (1)
Slide holder (1)
Microscope slides (2)
Cover slip (2)
Requisition slip (1)
Procedure form (1)

  • Labels for the kit and oil tube should be printed before kit assembly

Step 2: Print Requisition and Procedure Forms

Print the following two forms for inclusion in the kit. Right click on the image and choose "save as" to save to your computer. Then print copies as needed. (The requisition form is included in doc format for download as well.)

Or, you can choose use your own forms.

Step 3: Kit Template, Page 1

Print this!

This is one of two images which should be printed to serve as a template for making scabies skin scraping kits. Simply match each item to its picture on this template in order to ensure that all items are included in each kit.

Step 4: Kit Template, Page 2

Print this

This page serves as the second template for making skin scraping kits.

Step 5: Items Placed on Image Template

Here is an example of all kit items placed on the image template.

In order to expedite kit assembly, you can label and fill multiple oil tubes, and prepare slide holders (containing two slides and two cover slips) before-hand.

Assuming oil tubes and slide holders are prepared before-hand, a complete kit is composed of eleven (11) unique items, not counting labels.

1. Ziploc bag
2. Requisition Form
3. Procedure form
4. Pencil
5. Oil Tubes, labeled and filled
6. Prepared slide holder (containing two glass slides and two cover slips)
7. Bandage
8. Webcol (alcohol prep pad)
9. Safety scalpel
10. Two Gloves
11. Specimen Bag

Step 6: Skin Scraping Procedure

This video shows the appropriate pressure to exert on skin when doing a skin scraping for scabies.

Note: Scrapings must be from the infected area.

1. Identify the skin in the area to be scraped (between skin folds, red lines, pencil point like dots).
2. Scrape the skin with the edge of a scalpel blade. Use the lid of the inner carrier as a work-stage.
3. Transfer the material that is attached to the scalpel blade onto the glass slide by tapping gently.
4. Add 1 or 2 drops of mineral oil from the pierced oil segment to the slide, and mix of skin cells and oil.
5. Label the slides by writing the patient's last name, first name and date on the frosted part of the slides.
6. Place the slides in the slide carrier, tape it closed, and place in a biohazard bag. The bag should be accompanied by the appropriate form with relevant patient identification, clinical history, requesting physician and location of skin that had been scraped.

Step 7: Disclaimer

Read the disclaimer carefully!

Step 8: The End.

The end!
What is your opinion on Morgellon's? L
Interesting topic. The research relating to this, available to date, is suspect in that the images are poor, the documentation is sparse and the numbers are limited. There is also a "crossover" body of literature that explores aspects of delusional parasitosis. I think that discussion about this entity is still evolving. I suspect that more information might be gained by reviewing medical historical literature for similar findings. All skin scrapings will most likely include synthetic or organic materials that are adherent to the skin but are scraped off, for example synthetic fibers or animal (cat) hairs. Thanks for the comment. R
Thanks for your opinion as a professional. Do I take it that you're leaning towards delusional parasitosis as opposed to something medically interesting? L
Everything is potentially interesting to an Experimental Pathologist. I would need to see biopsy material, first hand and chemical analysis of the fibers. The problem is that there are several perspectives, sparse primary data (just anecdotes) and overlap between clinical presenations. There are no microscope images of skin biopsies that show an association to skin structures. Until that is done, no one can really offer anything of than a guess. In passing, the history of medicine is full of diseases that appeared then disappeared without a trace or explanation. Thanks for your comments. Cheers
Those are the things I'd ask for too. I am of the opinion that if you set up a website with enough keywords you'd be able to attract sufferers who would gladly give you what you needed (should you have the time / resources to investigate). Is is the sort of area most professionals would rather not be involved with? L
ah, the Straights of Morgellon! he's my favorite explorer, around the world in 80 days!
<strong>I think I threw-up a little in the back of my mouth.</strong><br/><br/>Seriously, as an ex-nurse I can see the value. Good job.<br/>
Thanks for the comment and excellent quote!
Goodness me, is this our first properly-medical Instructable?
Oh, pencil shavings. I'm late for <em>everything</em>. :-(<br/>
I'm hoping to put up some basic medical laboratory procedures, like "How to made a blood smear" or How to use a polarizing lens on a microscope". The Scabies Skin scraping Instructable will be useful for any state or Government's Visiting Nurse program as well as any Nursing home or school program. In many countries with restricted economies this basic procedure can be very useful in limiting infestation in crowded communities and groups. Cheers!
Gah! Credentials!

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