To the Editor.—
In their article describing a large multicenter study comparing lindane and permethrin treatment for scabies, Schultz et al1 fail to mention the criteria they used to establish the diagnosis of scabies. We, as dermatologists, know such a diagnosis to be suspect, at least to some extent, unless a mite is found among skin scrapings. Nonetheless, because of the illusiveness of those mites, many patients receive lindane without that proof. Happily, for a good clinician, most of those patients eventually recover, presumably because their scabies was cured. Such unscientific methods, however, do not befit a study attempting to mold our prescribing habits. If Schultz et al did not find a mite on each of their study patients, I consider their findings invalid.
Clayman JL. Did They See Mites?. Arch Dermatol. 1990;126(7):966-967. doi:10.1001/archderm.1990.01670310130025