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The Contrail Without Jet: How Dermatoscopy of Scabies Changes in Skin of Color

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Case Presentation

After examining upon dermatoscopy hundreds of black patients with scabies ( Figure 1A ), we noticed that the pigmented part of burrow (delta glider sign, corresponding to the anterior part of the mite) is often missing ( Figure 1B ).

Teaching Point

In latest years, a growing interest towards dermatology in skin of color is arising, with a special focus on dermatoscopy. Definitely, scabies is the infectious condition which mostly benefits from dermatoscopic diagnosis, with the so called “jet with contrail sign”, being the most typical and specific finding in Caucasians. Reasons for that phenomenon, almost never seen in a control group of Caucasians, may be different, including diffuse scaling due to intense scratching or pigmented background may render mite detection challenging.

The “contrail without jet” is worth noting in skin of color, with further larger studies still needed to confirm this singular sign.

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