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Treatment failure in scabies: a single-centre 5-year retrospective review
  1. Harry Coleman,
  2. Gulshan Cindy Sethi
  1. Burrell Street Clinic, Guy’s and St Thomas’ NHS Foundation Trust, London, UK
  1. Correspondence to Dr Harry Coleman, Guy's and St Thomas' NHS Foundation Trust, London, SE1 0UN, UK; harry.coleman{at}

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In 2017, the WHO formally designated scabies a neglected tropical disease.1 The prevalence of scabies is estimated to be >200 million cases worldwide. A UK study using data from the Health Information Network estimated the prevalence of scabies to be 2.27–2.81 per 1000.2 Risk factors for scabies include close contact with an infected individual, high levels of deprivation, crowded living conditions and winter months. Complications of scabies include secondary bacterial infection and the psychosexual impact.

Scabies, caused by the human ectoparasite Scarcoptes scabiei, is an intensely itchy infestation characterised by the burrowing of mites into the epidermis and subsequent tunnelling through the stratum corneum. The mite’s lifecycle lasts 4–6 weeks, during which the female mite lays around 25 eggs before dying, with the eggs maturing to adulthood in 10–15 days.3

Diagnosis of scabies is primarily made through clinical examination identifying burrows, mites, eggs or mite faeces. Microscopic examination of skin scrapings has low sensitivity.

Permethrin is recommended first-line treatment for scabies in the …

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  • Handling editor Anna Maria Geretti

  • Contributors HC—conception, design, collection of data and writing of letter. GCS—conception, design, review of article and supervision.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; internally peer reviewed.