Did They See Mites?

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.