ACTAS
Dermo-Sifiliográficas
114
(2023)
T433---T434
RESIDENT’S
FORUM
[Translated
article]
RF
---
Resistance
to
Permethrin
in
Scabies
Treatment:
Does
It
Really
Exist?
FR
---
¿Existe
una
resistencia
real
al
tratamiento
de
la
escabiosis
con
permetrina?
J.P.
Velasco-Amador,
A.
Prados-Carmona,
R.
Ruiz-Villaverde
∗
Servicio
de
Dermatología,
Hospital
Universitario
San
Cecilio,
Inst.
Invest.
Biosanitaria
IBS
Granada,
Granada,
Spain
KEYWORDS
Scabies;
Sarcoptes
scabiei
;
Permethrin;
Treatment;
Epidemic
PALABRAS
CLAVE
Escabiosis;
Sarna;
Permetrina;
Tratamiento;
Epidemia
Scabies
is
a
highly
contagious
skin
infestation
caused
by
the
Sarcoptes
scabiei
mite.
It
is
generally
transmitted
through
direct,
prolonged,
skin-to-skin
contact,
and
its
inci-
dence
increased
following
the
COVID-19
pandemic
and
home
DOI
of
original
article:
https://doi.org/10.1016/j.ad.2022.05.036
∗
Corresponding
author.
E-mail
address:
ismenios@hotmail.com
(R.
Ruiz-Villaverde).
confinement
measures.
1
The
first-line
treatment
for
scabies
is
5%
topical
permethrin
cream,
which
is
applied
from
head
to
toe
and
washed
off
after
8
to
12
hours.
This
treatment
is
repeated
after
7
to
14
days.
Cure
rates
of
up
to
98%
have
been
described
for
this
regimen,
1
but
recent
months
have
seen
an
increase
in
unsatisfactory
responses
to
treatment.
Treatment
failure
has
generally
been
attributed
to
var-
ious
causes,
including
incorrect
application
of
the
cream,
failure
to
simultaneously
treat
coinhabitants,
and
insuffi-
cient
disinfection
of
the
environment.
An
increasing
number
of
dermatologists,
however,
after
ruling
out
the
above
errors
and
achieving
cure
with
other
topical
treatments,
such
as
sulfur-containing
petroleum
jelly
and
sodium
benzoate,
are
suggesting
that
S.
scabiei
may
be
developing
true
resistance
to
permethrin.
In
2018,
Sunderkötter
et
al.
2
warned
of
an
increase
in
scabies
cases
in
Germany.
Among
the
possible
causes
they
mentioned
was
permethrin
resistance,
as
patients
did
not
respond
as
quickly
as
they
had
done
in
previous
years.
In
2020,
Meyersburg
et
al.
3
described
reduced
scabies
mite
susceptibility
to
permethrin
in
Austria
and
called
for
evaluation
of
alternative
treatment
options.
In
2021,
several
Italian
working
groups
also
recorded
a
loss
of
effectiveness
for
permethrin.
They
reported
that
almost
two-thirds
of
patients
in
whom
the
drug
had
failed
responded
to
another
topical
treatment,
suggesting
specific
https://doi.org/10.1016/j.ad.2022.05.046
0001-7310/©
2022
AEDV.
Published
by
Elsevier
Espa
̃
na,
S.L.U.
This
is
an
open
access
article
under
the
CC
BY-NC-ND
license
(
http://
creativecommons.org/licenses/by-nc-nd/4.0/
).