A Systematic Review of the Treatment of Scabies

Bigby, Michael

doi:10.1001/archderm.136.3.387

Cited by 15 publications

(6 citation statements)

References 8 publications

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“…The 5% permethrin preparation kills the organisms and eggs, and has an extremely low rate of absorption, making the toxicity potential non‐existent 15 . Resistance to permethrin in developed countries was reported in 1999 16 . Ivermectin is a novel antiparasitic agent effective against a variety of endoparasites and ectoparasites 17 .…”

Section: Discussionmentioning

confidence: 99%

Treatment of scabies: Comparison of permethrin 5% versus ivermectin

Goldust

Rezaee

Hemayat

2012

The Journal of Dermatology

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Scabies is an ectoparasitic, highly contagious skin disease caused by a mite called Sarcoptes scabiei. The insecticides ivermectin and permethrin are commonly used for treatment of scabies. This study aimed at comparing the efficacy of oral ivermectin with topical permethrin in treating scabies. Two hundred and forty-two patients with scabies attending the dermatology outpatient department of Sina Hospital, Tabriz University of Medical Sciences were admitted. Patients were divided into two groups randomly. The first group and their family contacts received 5% permethrin cream and the other received oral ivermectin. Treatment was evaluated at intervals of 2 and 4 weeks. A single dose of ivermectin provided a cure rate of 85.9% at a 2-week interval, which increased to 100% after crossing over to the permethrin group at a 4-week interval. Twice application of permethrin with a 1-week interval was effective in 92.5% of patients, which increased to 94.2% after crossing over to the ivermectin group at a 4-week interval. Permethrin-treated patients recovered earlier. Twice application of permethrin with a 1-week interval is superior to a single dose of ivermectin. The temporal dissociation in clinical response suggests that ivermectin may not be effective against all the stages in the life cycle of the parasite.

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Section: Discussionmentioning

confidence: 99%

Treatment of scabies: Comparison of permethrin 5% versus ivermectin

Goldust

Rezaee

Hemayat

2012

The Journal of Dermatology

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“…In accordance with the editorial by Bigby [4], commenting on a systematic review of the treatment of scabies by Walker and Johnstone [5], we will attempt to answer two questions in particular:…”

Section: Documentation Methodsmentioning

confidence: 99%

Current treatments for scabies

Buffet

Dupin

2003

Fundamemntal Clinical Pharma

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Scabies is a frequent interhuman ectoparasitic infection. Several treatments are available worldwide. There are local treatments: synthetic pyrethrins, benzyl benzoate, lindane, crotamiton. Recently a few studies were published concerning ivermectin, systemic antiparasitic agent use in onchocercosis treatment. We reviewed the literature with an evidence-based medicine method. We attempt to answer two questions in particular: what is the treatment of choice for common scabies in a patient otherwise in good health? What is the role of systemic ivermectin? We also report specific situations. Among local treatments, studies are heterogeneous according to products, countries, group of treated patients, with or without contact subjects, and the method of treatment application. There are very few high proof-level controlled studies. In France, a combination of benzyl benzoate 10% and sulfiram 2% is used most, according to professional consensus. The most studied product is the cream permethrin 5%, available in the USA and UK. Its efficacy seems slightly superior to lindane and less toxic. It is more efficient than crotamiton. There is no study comparing benzyl benzoate and permethrin. Concerning systemic ivermectin, five controlled studies showed its efficiency in common scabies. But its relative efficiency over local treatment has not been established. A few open studies showed its efficacy in institutional epidemic, profuse scabies and in HIV-positive patients. Local treatment of choice in common scabies remains to be determined among the four principal molecules. There is no study comparing permethrin or esdepallethrin to benzyl benzoate. In what cases should we prescribe crotamiton or lindane? Indication of ivermectin seems proved in common scabies and probably for HIV-positive patients. It remains to be determined if it should be prescribed in the first instance, be double or triple, be associated or not with local treatment. In case of keratotic scabies, ivermectin seems interesting with two applications within 1 week, and should be associated with local treatment (duration remains to be defined). Ivermectin is probably useful in institutional epidemic, and therapeutic attitude remains to be defined. Ivermectin seems to have little or no risk. Treatment must be adapted case-by-case, according to feasibility. It is still important to treat contacts, and modality of this treatment remains to be specified.

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“…Some patients may experience some irritation, burning sensation, irritation, or tingling, but all are of short duration and most probably related to be applied on skin that is already sensitive, excoriated, and pruritic because of the scabies infection (63), also because the preservative formaldehyde might be expected to cause some allergic contact dermatitis cases. A Cochrane meta‐analysis of four randomized trials comparing permethrin and lindane showed that permethrin, given as a single overnight application, was more effective than lindane (19,67). However, there was considerable heterogeneity in effects among studies.…”

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confidence: 99%

Scabies

Hicks¹,

Elston²

2009

Dermatologic Therapy

137

129

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Scabies is an ectoparasite caused by the mite Sarcoptes scabiei var hominis, an obligate human parasite. There are about 300 million cases of scabies in the world each year. Common predisposing factors are overcrowding, immigration, poor hygiene, poor nutritional status, homelessness, dementia, and sexual contact. Direct skin-to-skin contact between 15 and 20 minutes is needed to transfer the mites from one person to another. The diagnosis suspected with a clinical history of itch, worse at night, affecting other family members, clinical distribution, and appearance. Definite diagnosis relies on microscopic identification of the mites, eggs, or fecal pellets with 10% potassium hydroxide, ink enhancement, tetracycline fluorescence tests, or mineral oil; other methods include: epiluminescence light microscopy and S. scabiei DNA. The most commonly used treatment modalities are permethrin and ivermectin. Persistence of symptoms for 2-6 weeks after successful treatment is common. Most recurrences are because of reinfection from untreated contacts.

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A Systematic Review of the Treatment of Scabies

Cited by 15 publications

References 8 publications

Treatment of scabies: Comparison of permethrin 5% versus ivermectin

Treatment of scabies: Comparison of permethrin 5% versus ivermectin

Current treatments for scabies

Scabies

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