492 The usefulness of an inexpensive, battery-powered, handheld microscope in low-resource dermatologic practices

Abstract

Previous studies in low- and middle-income countries have shown that skin disease is very common, especially dermatophyte and scabies infections. Point-of-care microscopic evaluation of skin scraping samples improves the diagnostic accuracy of these skin pathologies. Resource limitations, however, often preclude the use of microscopy for point-of-care evaluations in low- and middle-income countries. An inexpensive (<USD$20), hand-held, battery-powered LED microscope was field-tested for potassium hydroxide (KOH) and mineral oil examinations of skin scrapings from participants who complained of a rash. The study was conducted in collaboration between the University of Utah School of Medicine and the Kwame Nkrumah University of Science & Technology School of Medical Sciences in the Atwima Nwabiagya North District in the Ashanti region of Ghana, West Africa. A board-certified dermatologist was able to microscopically confirm dermatophyte and scabies infections, which comprised 16.4% (35/213) of all evaluated skin conditions. An inexpensive, hand-held, battery-powered LED microscope can be used to effectively diagnose certain skin diseases in remote locations without the need for electricity. This point-of-care testing is readily learnable by any clinician, staff member or pharmacist. Using microscopy improves the diagnostic accuracy of skin conditions and choice of therapy and minimizes unnecessary side effects of commonly-used combination treatments.