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September 14, 1984

Scabies: Subungual Areas Harbor Mites

Author Affiliations

From the Departments of Dermatology, University of Pennsylvania School of Medicine (Dr Witkowski) and Jefferson Medical College of Thomas Jefferson University (Dr Parish), Philadelphia.

JAMA. 1984;252(10):1318-1319. doi:10.1001/jama.1984.03350100048029

ANECDOTAL reports have been circulating that the usefulness of lindane in the treatment of scabies has been waning. A patient with scabies was said to have mites resistant to lindane when in fact only crotamiton had been used. Resistance of Sarcoptes scabiei to this agent is known to exist,1 although in vivo or in vitro resistance to lindane has not been reported. We recently saw a patient with scabies whose condition was thought initially to be resistant to lindane until the mites were discovered in the subungual spaces.

Report of a Case  A 72-year-old woman was hospitalized for rheumatoid arthritis, diabetes mellitus, dehydration, iron-deficiency anemia, reflux esophagitis, and severe pruritus. She was being treated with acetominophen, cimetidine, desipramine hydrochloride, diphenhydramine hydrochloride, ferrous sulfate, propoxyphene napsylate, and a diabetic diet. The pruritus had been present for six months; although she was conscious of it throughout the day, it was most