133 urn:lsid:arphahub.com:pub:3743a65a-6869-528e-a7d9-aa502935b7f6 SKINdeep skinonline 3061-029X 3061-0281 Austrian Academy of Sciences Press 10.1553/skindeep.2026.183007 183007 Letter to the editor Infectious diseases Mites Diagnosis of a case of scabies infestation with line-field confocal optical coherence tomography Muller Nicholas M. nicholas.muller@student.uq.edu.au https://orcid.org/0000-0002-6294-4109 1 2 Conceptualization Writing - original draft Data curation Visualization Tan Samuel X. https://orcid.org/0000-0002-2343-1378 1 2 Writing - original draft Methodology Visualization Nufer Kaitlin https://orcid.org/0000-0002-2813-1518 1 2 Data curation Methodology Darch Katherine https://orcid.org/0000-0003-1191-5655 1 Formal analysis Supervision van Rooij Nicholas 1 Writing - review and editing Supervision Khosrotehrani Kiarash https://orcid.org/0000-0002-6406-4076 1 2 Conceptualization Funding acquisition Project administration Resources Software Supervision Soyer H. Peter https://orcid.org/0000-0002-4770-561X 1 2 Writing - review and editing Supervision Manahan Melissa 1 Conceptualization Supervision Wu Jason 1 Conceptualization Project administration Resources Supervision Validation Department of Dermatology, Princess Alexandra Hospital, Woolloongabba, QLD, Brisbane, Australia Frazer Institute, The University of Queensland Dermatology Research Centre Brisbane Australia https://ror.org/00rqy9422 Frazer Institute, The University of Queensland Dermatology Research Centre, Woolloongabba, QLD, Brisbane, Australia Department of Dermatology, Princess Alexandra Hospital Brisbane Australia https://ror.org/04mqb0968

Corresponding author: Nicholas M. Muller (n.muller@uq.edu.au)

 2026 23 02 2026 2 e183007 5AE7EA1D-C514-5AE8-AF66-9319D85E0E06 0 19 12 2025 29 01 2026 Nicholas M. Muller, Samuel X. Tan, Kaitlin Nufer, Katherine Darch, Nicholas van Rooij, Kiarash Khosrotehrani, H. Peter Soyer, Melissa Manahan, Jason Wu This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY-NC 4.0), which permits to copy and distribute the article for non-commercial purposes, provided that the article is not altered or modified and the original author and source are credited.

We present a case of scabies diagnosed with LC-OCT with a video of the live scan across the volume of the scabietic burrow.

 General dermatology diagnosis confocal microscopy scabies line-field optical coherence tomography <p>Dear Editor,</p> <p>Diagnosis of infestation by <italic><tp:taxon-name><tp:taxon-name-part taxon-name-part-type="genus" reg="Sarcoptes">Sarcoptes</tp:taxon-name-part> <tp:taxon-name-part taxon-name-part-type="species" reg="scabiei">scabiei</tp:taxon-name-part></tp:taxon-name></italic> can fox even the experienced dermatologist, particularly in those patients lacking the more classical signs. Our diagnostic armamentarium can often be found lacking with many modalities having poor sensitivity (microscopy of skin scrapings = 56.3% and dermoscopy = 43.5%) [<xref ref-type="bibr" rid="B1">1</xref>]. Recent studies have demonstrated the use of line-field confocal optical coherence tomography (LC-OCT) as a non-invasive diagnostic alternative [<xref ref-type="bibr" rid="B2 B3 B4 B5">2–5</xref>]. Here we present a case of recurrent scabies diagnosed with the assistance of LC-OCT and confirmed with microscopy to add to the body of literature supporting this modality for diagnosis.</p> <p>Full skin examination of a 42-year-old female revealed a widespread, erythematous, papular eruption without specific features in the interdigital web spaces or on the volar aspects of the wrists. Dermatoscopic examination demonstrated a lesion suspicious for a scabietic burrow [Figure <xref ref-type="fig" rid="F1">1A</xref>], which was further interrogated using LC-OCT imaging [Figure <xref ref-type="fig" rid="F2">2</xref>] with the Damae Medical produced deepLive<sup>TM</sup> device. Scrapings from the lesion were examined under light microscopy [Figure <xref ref-type="fig" rid="F1">1B</xref>]. The diagnosis of scabies was confirmed, and the patient was treated with a course of ivermectin and instructed on the use of permethrin 5% cream and household measures to ensure clearance of the infestation.</p> <p>Figure <xref ref-type="fig" rid="F1">1</xref> depicts the dermatoscopic image of the burrow [Figure <xref ref-type="fig" rid="F1">1A</xref>] and the microscopic confirmation of the mite [Figure <xref ref-type="fig" rid="F1">1B</xref>]. Figure <xref ref-type="fig" rid="F2">2</xref> depicts frame from a live video scan through the horizontal and vertical axes of the LC-OCT imagery, matched with the position within the dermatoscopic image. We see the tortuous burrow through the epidermis containing an adult mite on the far left (300 µm wide and 150 µm from the side of the frame where the rest of the mite has been cut off). Two eggs are seen mid right and far right, measuring around 100 µm in diameter.</p> <fig id="F1" position="float" orientation="portrait"> <object-id content-type="doi">10.1553/skindeep.2026.183007.figure1</object-id> <object-id content-type="arpha">593D037F-8773-501F-8362-BD56F7D577D7</object-id> <label>Figure 1.</label> <caption> <p>Dermatoscopic image (<bold>A</bold>) of scabies burrow and microscopic image (<bold>B</bold>) of scabies mite scraped from the lesion.</p> </caption> <graphic xlink:href="skinonline-02-001_article-183007__-g001.jpg" position="float" orientation="portrait" xlink:type="simple" id="oo_1547114.jpg"> <uri content-type="original_file">https://binary.pensoft.net/fig/1547114</uri> </graphic> </fig> <fig id="F2" position="float" orientation="portrait"> <object-id content-type="doi">10.1553/skindeep.2026.183007.figure2</object-id> <object-id content-type="arpha">94A2C4E6-AE61-5506-A8EC-1961EE6FFAA4</object-id> <label>Figure 2.</label> <caption> <p>Line-field confocal optical coherence tomography images of scabies mite (*), burrow and eggs (white arrows) as vertical (<bold>A</bold>) and horizontal views (<bold>B</bold>) with corresponding dermatoscopic image (<bold>C</bold>).</p> </caption> <graphic xlink:href="skinonline-02-001_article-183007__-g002.jpg" position="float" orientation="portrait" xlink:type="simple" id="oo_1547115.jpg"> <uri content-type="original_file">https://binary.pensoft.net/fig/1547115</uri> </graphic> </fig> </sec> </body> <back> <sec sec-type="Additional information" id="SECID0E5AAC"> <title>Additional information Conflict of interest

HPS is a shareholder of MoleMap NZ LTD and e-Derm Consult GmbH and undertakes regular teledermatological reporting for both companies, he is a Medical Consultant for Canfield Scientific Inc. and a Medical Advisor for First Derm. The remaining authors declare that this work was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

 Ethical statements

The authors declared that no clinical trials were used in the present study.

Informed consent from the humans, donors or donors’ representatives: Princess Alexandra Hospital, Brisbane, Australia.

The authors declared that no experiments on animals were performed for the present study.

The authors declared that no commercially available immortalised human and animal cell lines were used in the present study.

 Use of AI

AI was used for correcting spelling and grammar errors.

 Funding

No funding was reported.

 Author contributions

Nicholas M. Muller and Samuel X. Tan contributed equally and are co-lead authors. Conceptualization: JW, MM, NMM, KK. Data curation: NMM, KN. Formal analysis: KD. Funding acquisition: KK. Methodology: KN, SXT. Project administration: KK, JW. Resources: JW, KK. Software: KK. Supervision: HPS, KK, KD, MM, NR, JW. Validation: JW. Visualization: SXT, NMM. Writing – original draft: SXT, NMM. Writing – review and editing: NR, HPS.

 Author ORCIDs

Nicholas M. Muller https://orcid.org/0000-0002-6294-4109

Samuel X. Tan https://orcid.org/0000-0002-2343-1378

Kaitlin Nufer https://orcid.org/0000-0002-2813-1518

Katherine Darch https://orcid.org/0000-0003-1191-5655

Kiarash Khosrotehrani https://orcid.org/0000-0002-6406-4076

H. Peter Soyer https://orcid.org/0000-0002-4770-561X

 Data availability

All of the data that support the findings of this study are available in the main text or Supplementary Information.

 References Shoukat Q, Rizvi A, Wahood W, Coetzee S, and Wrench A. Sight the Mite: A Meta-Analysis on the Diagnosis of Scabies. Cureus 2023;15(1):e34390. https://doi.org/10.7759/cureus.34390 Idoudi S, Battistella M, El zeinaty P, Tavernier C, Lebbe C, and Baroudjian B. Line-field confocal optical coherence tomography in vivo description of Sarcoptes scabiei and histological correlation. J Eur Acad Dermatol Venereol 2024;38(10):e874–e876. https://doi.org/10.1111/jdv.19972 Ruini C, Schuh S, Hartmann D, French L, Welzel J, and Sattler E. Noninvasive real‐time imaging of mite skin infestations with line‐field confocal optical coherence tomography. Br J Dermatol 2021;184(1):e3–e3. https://doi.org/10.1111/bjd.19318 Orsini C, Taddeucci P, Bertello M, Cinotti E, Cortonesi G, Rubegni P, et al. Line-field confocal optical coherence tomography for the diagnosis of nodular scabies mimicking breast cancer skin metastasis. Int J Dermatol 2023;62(3):e195–e196. https://doi.org/10.1111/ijd.16457 Kofler L, Cambaz U, Heinecke M, Hubert G, and Kofler K. Correlation of dermatoscopy and LC-OCT as a diagnostic extension for scabies. J Dtsch Dermatol Ges 2025. https://doi.org/10.1111/ddg.15945

Nicholas M. Muller and Samuel X. Tan contributed equally to this work

 Supplementary materials 10.1553/skindeep.2026.183007.suppl1 FE0F1965-D9EB-54D5-B56C-C174507AFD7E

Supplementary figure S1

mp4

Live line-field confocal optical coherence tomography scan through a scabies burrow, from Figure 2. Available at https://doi.org/10.6084/m9.figshare.31066333.

 https://binary.pensoft.net/file/1547116 This dataset is made available under the Open Database License (http://opendatacommons.org/licenses/odbl/1.0/). The Open Database License (ODbL) is a license agreement intended to allow users to freely share, modify, and use this Dataset while maintaining this same freedom for others, provided that the original source and author(s) are credited. Nicholas M. Muller, Samuel X. Tan, Kaitlin Nufer, Katherine Darch, Nicholas van Rooij, Kiarash Khosrotehrani, H. Peter Soyer, Melissa Manahan, Jason Wu