A baby brought in the Skin OPD of Dermatological department with his parents. In OPD doctor is doing Burrows ink Test (BIT) for the baby. This test is commonly used to diagnose which skin disease?

1. A

   Vitiligo

2. B

   Scabies

3. C

   Impetigo

4. D

   Psoriasis

Appeared in: NORCET 3 - 2022 (Shift-2)

Explanation

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• The Burrow's Ink Test (BIT) is specifically designed to visualize the burrows created by the Sarcoptes scabiei mite in the stratum corneum.
• When ink is applied to a suspected lesion and then wiped away, it gets trapped in the mite's tunnel, revealing a characteristic thin, wavy, or serpentine line, which confirms the diagnosis.
• This test provides a quick, non-invasive confirmation at the bedside when classic burrows are suspected but are difficult to see with the naked eye.

Why Other Options Were Wrong

• Option A: Vitiligo is an autoimmune condition causing depigmented skin patches due to loss of melanocytes. It does not involve any burrowing organisms.
• Option C: Impetigo is a superficial bacterial skin infection, typically caused by Staphylococcus aureus or Streptococcus pyogenes, characterized by honey-colored crusts.
• Option D: Psoriasis is a chronic autoimmune disease that causes rapid skin cell turnover, leading to erythematous plaques with silvery scales. It is not an infestation and has no burrows.

Related Visual

Clinical Relevance

• Nursing practice connection: Knowing Diagnostic procedure for scabies infestation helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
• Accurate diagnosis of scabies is crucial to initiate appropriate treatment with scabicides and prevent transmission to family members and close contacts, preventing outbreaks in settings like schools, daycares, and nursing homes.
• Nurses must educate the patient and family that intense itching can persist for 2-4 weeks even after successful treatment. This is due to a hypersensitivity reaction to dead mites and their waste products, not treatment failure.
• All household members and close contacts should be treated simultaneously, even if they do not have symptoms, to prevent re-infestation.

How to Approach the Question

• First, identify the key term in the question: 'Burrows ink Test (BIT)'.
• The name of the test itself contains a major clue: 'Burrow'. This strongly suggests the test is designed to identify a condition that involves burrowing in the skin.
• Next, analyze the options based on their pathophysiology. Ask yourself which of these diseases is caused by an organism that burrows.
• Recall or deduce that Vitiligo is about pigment loss, Impetigo is a bacterial infection with crusts, and Psoriasis involves autoimmune plaques and scales.
• Recognize that Scabies is an infestation caused by the itch mite, which burrows into the skin to lay eggs. This pathophysiology directly matches the clue from the test's name.
• Therefore, conclude that the Burrow's Ink Test is the correct diagnostic tool for Scabies.

Concept Tested & Keywords

• Concept Tested: Diagnostic procedure for scabies infestation
• Stem keywords: Burrows ink Test, BIT, diagnose, skin disease
• Lead-in keywords: which
• Clinical cues: The name of the test 'Burrows ink Test' is a direct clue to the pathophysiology of the disease it diagnoses.
• Negative lead-in flag: false

Question ID

qjgiZZJ6l5XwJnyz7Ls57

Copy ID

Reference Book

E6 Medicine Harrison 22e Part 2 p. 1633-1635

E6 Ghai Essential Pediatrics(pp 26-904 of 913) p. 741-743

E6 Nursing Brunner Adult Health 3SA Vol 1 Part 4 p. 61-63