Permethrin-unresponsive scabies in London, UK: a wake-up call

Failure to respond to permethrin, the most widely prescribed first-line therapy for scabies, has been increasingly reported in recent years in a number of countries. However, its true scale and relation to verifiable permethrin resistance is currently unknown. We present a case of scabies associated with scabetic nodules in which a lack of response to topical permethrin treatment was evident.