Letters to the Editor
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https://doi.org/10.4081/dr.2026.10955

Why does classic scabies spare the adult scalp? A site-specific barrier hypothesis

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Published: 19 October 2026
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Scabies, Sarcoptes scabiei, scalp, skin barrier, skin microbiome, Malassezia, sebaceous skin

Authors

Caterina Mariarosaria Giorgio
caterinagiorgio80@gmail.com
Dermatology Unit, University of Campania “Luigi Vanvitelli”, Naples, Italy.
Gaetano Licata
Section of Dermatology, Department of Health Promotion, Maternal-Infant, Internal Medicine and Specialization of Excellence “G. D’Alessandro”, University of Palermo, AOUP Paolo Giaccone, Palermo, Italy.
Giuseppe Argenziano
Dermatology Unit, University of Campania “Luigi Vanvitelli”, Naples, Italy.

Dear Editor,

The relative sparing of the scalp and face in immunocompetent adults with classic scabies is clinically familiar, whereas these sites may be involved in infants, older adults, immunocompromised patients, and crusted scabies. This distribution is commonly used as a diagnostic clue, but its biological basis remains incompletely explained. [...]

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Citations

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1.
Why does classic scabies spare the adult scalp? A site-specific barrier hypothesis. Dermatol Reports [Internet]. 2026 Oct. 19 [cited 2026 Oct. 19];. Available from: https://journals.pagepress.net/dr/article/view/10955
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