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Purely cutaneous Rosai–Dorfman disease is a self-limiting and benign histiocytosis; however, some patients may be concerned about the aesthetic appearance, with a negative effect on quality of life. Even though many treatments have been proposed, no specific therapies are available and there is insufficient evidence supporting the superiority of any particular approach. Here we report the improvement of purely cutaneous Rosai–Dorfman disease with topical rapamycin.

As Sarcoptes scabiei is becoming less sensitive to permethrin, clinicians have started to prescribe oral ivermectin (OI) as a first-line treatment. Guidelines suggest OI 200 µg kg–1 as two doses, 1 week apart. However, the black box of the ivermectin registered in Italy recommends a single dose. To compare these two regimens, we collected 71 cases of scabies and treated them according to this protocol [single-dose group (SDG)]. This population was compared to 68 patients who received two doses 1 week apart [double-dose group (DDG)]. Clearance of the disease was achieved in 98% of DDG patients. In the SDG, treatment was successful in only 58% of patients. This study confirms that the absence of a second intake of OI is one of the main predictors of treatment failure (P < 0.001), which may also increase the likelihood of emerging resistance in S. scabiei.