Crusted scabies and multiple dosages of ivermectin

We present the case of a bone marrow transplant patient who was diagnosed with crusted scabies but did not respond to the usual approach with topical permethrin and ivermectin. The Centers for Disease Control and Prevention were contacted and suggested a 7-dose regimen of ivermectin. The patient started to improve remarkably after the third dose, and the skin eruption was resolved after 7 doses. This case supports the use of a more prolonged course of oral ivermectin for crusted scabies in those who fail the conventional approach.