A 33-year-old woman with a recent diagnosis of scabies presents with recurrent itching and rash on her hands and forearms. She was treated 3 weeks prior with permethrin cream. Her symptoms initially resolved, but then resurfaced 2 days prior to the current presentation. She reports applying the cream to her entire body from the neck down and rinsing 14 hours later, as directed. She did not take any additional measures in her home. Examination reveals burrows and feces on a skin scraping.