Burrow Ink Test for Scabies

A 20-year-old man with a 3-month history of generalized pruritus and recent sexual exposure presented with erythematous papules on the trunk, genitals, and wrists. No visible burrows were seen, but a positive burrow ink test on the wrist revealed ink-filled serpiginous lines, pathognomonic for scabies, caused by Sarcoptes scabiei var. hominis. This test uses a skin marker and alcohol swab to expose burrows, offering a quick, inexpensive method for diagnosis. However, a negative test does not exclude disease, and dermoscopy or skin scraping may be needed. Treatment included oral ivermectin and topical permethrin, with contact tracing and partner therapy. Symptoms resolved after 4 weeks.

A 20-year-old man with a 3-month history of generalized pruritus and recent sexual exposure presented with erythematous papules on the trunk, genitals, and wrists. No visible burrows were seen, but a positive burrow ink test on the wrist revealed ink-filled serpiginous lines, pathognomonic for scabies, caused by Sarcoptes scabiei var. hominis. This test uses a skin marker and alcohol swab to expose burrows, offering a quick, inexpensive method for diagnosis. However, a negative test does not exclude disease, and dermoscopy or skin scraping may be needed. Treatment included oral ivermectin and topical permethrin, with contact tracing and partner therapy. Symptoms resolved after 4 weeks.