This study systematically reviewed the accuracy and precision of history, physical examination and tests for diagnosing scabies. Using a structured search strategy, Medline and Embase databases were searched for English and French language articles that included a diagnosis of scabies. Studies comparing history, physical examination and/or any diagnostic tests with the reference standard of microscopic visualization of mites, eggs or fecal elements obtained from skin scrapings or biopsies were included for analysis. History and examination of pruritic dermatoses failed to accurately diagnose scabies infection. The accuracy of dermatoscopy, performed by a trained practitioner, was determined; however, the accuracy of other diagnostic tests could not be calculated from the data in the literature. In the face of such diagnostic inaccuracy, research to identify or develop accurate diagnostic tests for scabies infection is needed and justifiable.BACKGROUND: Accurate diagnosis of scabies infection is important for patient treatment and for public health control of scabies epidemics.OBJECTIVE: To systematically review the accuracy and precision of history, physical examination and tests for diagnosing scabies.METHODS: Using a structured search strategy, Medline and Embase databases were searched for English and French language articles that included a diagnosis of scabies. Studies comparing history, physical examination and/or any diagnostic tests with the reference standard of microscopic visualization of mites, eggs or fecal elements obtained from skin scrapings or biopsies were included for analysis. Data were extracted using standard criteria.RESULTS: History and examination of pruritic dermatoses failed to accurately diagnose scabies infection. Dermatoscopy by a trained practitioner has a positive likelihood ratio of 6.5 (95% CI 4.1 to 10.3) and a negative likelihood ratio of 0.1 (95% CI 0.06 to 0.2) for diagnosing scabies. The accuracy of other diagnostic tests could not be calculated from the data in the literature.CONCLUSIONS: In the face of such diagnostic inaccuracy, clinical judgment is still practical in diagnosing scabies. Two tests are used – the burrow ink test and handheld dermatoscopy. The burrow ink test is a simple, rapid, noninvasive test that can be used to screen a large number of patients. Handheld dermatoscopy is an accurate test, but requires special equipment and trained practitioners. Given the morbidity and costs of scabies infection, and that studies to date lack adequate internal and external validity, research to identify or develop accurate diagnostic tests for scabies infection is needed and justifiable.

中文翻译：

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疥疮的检测：诊断方法的系统回顾。


本研究系统地评价了诊断疥疮的病史、体格检查和测试的准确性和精确度。使用结构化搜索策略，在 Medline 和 Embase 数据库中搜索了包含疥疮诊断的英语和法语文章。将病史、体格检查和/或任何诊断测试与从皮肤刮片或活组织检查中获得的螨虫、虫卵或粪便成分的显微镜观察参考标准进行比较的研究均纳入分析。瘙痒性皮肤病的病史和检查未能准确诊断疥疮感染。由经过培训的医生进行的皮肤镜检查的准确性已得到确定；然而，其他诊断测试的准确性无法根据文献中的数据计算出来。面对这种诊断不准确的情况，需要进行研究来识别或开发疥疮感染的准确诊断测试，并且是合理的。背景：疥疮感染的准确诊断对于患者治疗和疥疮流行的公共卫生控制非常重要。目的：系统评价疥疮感染病史、体格检查和疥疮诊断测试的准确性和精确度。方法：使用结构化搜索策略，在 Medline 和 Embase 数据库中搜索包含疥疮诊断的英语和法语文章。将病史、体格检查和/或任何诊断测试与从皮肤刮片或活组织检查中获得的螨虫、虫卵或粪便成分的显微可视化参考标准进行比较的研究均被纳入分析。使用标准标准提取数据。结果：瘙痒性皮肤病的病史和检查未能准确诊断疥疮感染。 由训练有素的医生进行的皮肤镜检查诊断疥疮的阳性似然比为 6.5（95% CI 4.1 至 10.3），阴性似然比为 0.1（95% CI 0.06 至 0.2）。无法根据文献中的数据计算其他诊断测试的准确性。结论：面对这种诊断不准确性，临床判断在诊断疥疮中仍然实用。使用两种测试——洞穴墨水测试和手持式皮肤镜检查。洞穴墨水测试是一种简单、快速、无创的测试，可用于筛查大量患者。手持式皮肤镜检查是一种准确的测试，但需要特殊设备和训练有素的从业人员。考虑到疥疮感染的发病率和费用，以及迄今为止的研究缺乏足够的内部和外部有效性，需要进行研究来识别或开发疥疮感染的准确诊断测试，并且是合理的。