I applaud the efforts of Chouela et al1 in confirming the efficacy and safety of ivermectin for treating human scabies. Scabies can be difficult to diagnose and the regulations of the Clinical Laboratory Improvement Amendments of 19982 have severely hampered the dermatologist from making bedside diagnoses in nursing home patients. The sequelae of missed diagnoses of scabies in nursing home patients in the memory loss unit, where I consult, recently resulted in costs of $15,000 for cleaning and medications. Easily administered and safe oral treatments are welcome for the persistent and potentially serious problem of scabies and the subsequent costs. I agree with Chouela et al1 that further studies are necessary to confirm the long-term safety and efficacy of ivermectin for the treatment of scabies, especially among immunosuppressed and pediatric patients.
Altman JS. Ivermectin for Scabies. Arch Dermatol. 1999;135(12):1550. doi:10-1001/pubs.Arch Dermatol.-ISSN-0003-987x-135-12-dlt1299