Scabies: permethrin resistance and role of ivermectin. Results of an Italian consensus

Resistance to permethrin in patients with scabies emerged in recent years both in Italy and in the rest of Europe. A panel of nine Italian dermatologists with expertise in scabies was convened to address 23 questions regarding scabies therapy. Only agreement/disagreement responses were accepted. A unanimous conclusion emerged: permethrin should no longer be considered as first-line therapy for scabies in Italy. Benzyl benzoate was considered a reasonable alternative by two-thirds of the experts, although concentration and optimal formulation remain unclear and warrant further investigation. Full agreement was reached about ivermectin as first-line therapy. Ivermectin should be considered as the therapy of choice in patients with scabies.