Demographic Characteristics, Clinical Presentations, and Dermoscopic Patterns among Patients with Scabies at a Nigerian Tertiary Hospital: A Cross-Sectional Study.

BACKGROUND: Scabies is a highly contagious parasitic infestation that causes substantial morbidity, especially in low-resource tropical regions. Diagnostic limitations, particularly poor sensitivity of microscopy and the impact of dark skin pigmentation on lesion visibility, contribute to persistent transmission. Dermoscopy offers a rapid, non-invasive method of direct visualization of mites, yet evidence from Africa remains scarce. This study evaluates the demographic characteristics, clinical presentation, and the diagnostic accuracy of dermoscopy compared with skin scraping microscopy among patients with clinically suspected scabies in Southeast Nigeria. METHODOLOGY: A cross-sectional study was conducted among consecutively recruited, consenting participants with symptoms suggestive of scabies at the Dermatology clinic of the University of Nigeria Teaching Hospital (UNTH), Enugu, between March 2021 and March 2022. Sociodemographic characteristics, Clinical presentation, and dermoscopic assessment using a smartphone dermatoscope at × 200 magnification were obtained, with confirmatory skin-scraping microscopy. Sensitivity, specificity, predictive values, and 95% confidence intervals were calculated. RESULTS: Among 170 patients (mean age 26.9 ± 17.2 years; 55.3% female). Dermoscopy identified mites in 86.5% of participants, while microscopy confirmed mites or eggs in 41%. Compared with microscopy, dermoscopy demonstrated a sensitivity of 100%, specificity of 16%, positive predictive value of 45%, and negative predictive value of 100% relative to microscopy. The "Delta Jet Wing" sign was observed in 71.8% of cases on dermoscopy. CONCLUSION: Scabies predominantly occurred among young adult females of lower socioeconomic status with papules as its most common clinical presentation. Dermoscopy demonstrates excellent sensitivity but poor specificity and is a useful diagnostic tool for scabies in resource-limited settings. Its integration into clinical dermatology practice in Nigeria may significantly improve early detection and limit community transmission.