Dermatology: Practical and Conceptual


Image Letter | Dermatol Pract Concept. 2024;14(1):e2024080 1

The Contrail Without Jet: How Dermatoscopy 
of Scabies Changes in Skin of Color

Vincenzo Piccolo1, Giuseppe Argenziano1, Aimilios Lallas2, Teresa Russo1, Enzo Errichetti3

1 Dermatology Unit, University of Campania, Naples, Italy

2 Institute of Dermatology, “Santa Maria della Misericordia” University Hospital, Udine, Italy

3 First Department of Dermatology, Aristotle University, Thessaloniki, Greece

Citation: Picolo V, Argenziano G, Lallas A, Russo T, Errichetti E. The Contrail Without Jet: How Dermatoscopy of Scabies Changes in Skin 
of Color. Dermatol Pract Concept. 2024;14(1):e2024080. DOI: https://doi.org/10.5826/dpc.1401a80

Accepted: September 5, 2023; Published: January 2024

Copyright: ©2024 Piccolo et al. This is an open-access article distributed under the terms of the Creative Commons Attribution-
NonCommercial License (BY-NC-4.0), https://creativecommons.org/licenses/by-nc/4.0/, which permits unrestricted noncommercial use, 
distribution, and reproduction in any medium, provided the original authors and source are credited.

Funding: None.

Competing Interests: None.

Authorship: All authors have contributed significantly to this publication.

Corresponding Author: Vincenzo Piccolo, MD, c/o II Policlinico, Edificio 9, Primo piano, Via Pansini 5 - 80131 Napoli, Italy.  
Tel: +39-0815666834 FAX: +39-0815468759 E-mail: piccolo.vincenzo@gmail.com

Case Presentation

After examining upon dermatoscopy hundreds of black 

patients with scabies (Figure 1A), we noticed that the pig-

mented part of burrow (delta glider sign, corresponding to 

the anterior part of the mite) is often missing (Figure 1B).

Teaching Point

In latest years, a growing interest towards dermatology in 

skin of color is arising, with a special focus on dermatoscopy. 

Definitely, scabies is the infectious condition which mostly 

benefits from dermatoscopic diagnosis, with the so called 

Figure 1. (A) A 7-year-old African child with a diffuse itchy eruption of the trunk. (B) The contrail without 

jet seen at dermatoscopy; the mite is probably confounded in the context of dark background of the patient.



2 Image Letter | Dermatol Pract Concept. 2024;14(1):e2024080

“jet with contrail sign”, being the most typical and specific 

finding in Caucasians. Reasons for that phenomenon, almost 

never seen in a control group of Caucasians, may be differ-

ent, including diffuse scaling due to intense scratching or pig-

mented background may render mite detection challenging.

The “contrail without jet” is worth noting in skin of 

color, with further larger studies still needed to confirm this 

singular sign.