Abstract: 【Abstract】 Objective To investigate reflectance confocal microscopic features of childhood scabies, and to analyze clinical significance of reflectance confocal microscopy （RCM） in the diagnosis and treatment of childhood scabies. Methods A retrospective analysis was performed in 77 children with confirmed scabies at Department of Dermatology, Tianjin Children′s Hospital from April 2018 to October 2019. These patients were divided into negative treatment history group （61 cases） and positive treatment history group （16 cases）. All the patients underwent RCM and microscopic examination of skin scrapings. Results Among the 77 children with scabies, positive microscopic examination results were found in 33 （42.86%）, including 28 in the negative treatment history group and 5 in the positive treatment history group. Burrows, sarcoptid mites or their eggs and fecal pellets were observed in 56 cases （72.73%） by RCM, including 49 （80.33%） in the negative treatment history group and 7 in the positive treatment history group. RCM showed a significantly increased overall positive rate compared with microscopy of skin scrapings （χ2 = 14.08, P＜0.05）. In the negative treatment history group, RCM also showed a significantly increased positive rate compared with microscopy of skin scrapings （χ2 = 15.53, P < 0.05）. Conclusion RCM is of high clinical value to the diagnosis and treatment of childhood scabies.

Key words: Scabies, Microscopy, confocal, Child, Sarcoptes scabiei, Diagnosis