Topical ivermectin: an off‐label alternative to treat neonatal Scabies in the era of permethrin resistance

Bassi, Andrea; Piccolo, Vincenzo; Argenziano, Giuseppe

doi:10.1111/jdv.18026

Cited by 11 publications

(3 citation statements)

References 9 publications

(28 reference statements)

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“…Combined therapy with oral ivermectin and topical benzyl benzoate seems to be the best therapeutic approach, with 100% treatment success in newly diagnosed patients and patients unresponsive to permethrin [12]. In infants weighing less than 15 kg, topical ivermectin is recommended [13]. According to our data, permethrin lotion negatively affected treatment success.…”

Section: Discussionmentioning

confidence: 71%

Factors Affecting Topical Treatment Success in Pediatric Scabies Cases: A Cross-Sectional Study

Oba,

Özkoca,

Başara Şahin

et al. 2023

Dermatol Pract Concept

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Introduction: Scabies is a common disease affecting the pediatric population. Treatment failure and relapses are frequent. Objectives: We aimed to define factors affecting topical treatment success in pediatric scabies patients. Methods: This multicenter cross-sectional study was performed between April and December 2022. Pediatric scabies cases were classified as treatment failure (TF) versus treatment success (TS). Results: We enrolled 170 patients in the study. In the TF group, the presence of symptomatic household members and referral from physicians other than dermatologists were more common (both p<0,001) and relapse rates and total symptom duration were higher (p=0,007, p<0,001 respectively). Permethrin 5% was more commonly used in the TF group (71.1% versus 25%) (p<0,001); however, the ratio of patients treated with sulfur preparations was significantly higher in the TS group (60.7% vs 16.9%) (p<0,001). Misapplication of topical therapy was significantly more common in the TF group (p<0,001), statistically significant errors being: (i) lack of treatment of close contacts (p<0,001); (ii) single application (p<0,001); and (iii) local application (p=0,027). In a multivariate analysis, treatment success was mainly associated with (i) presence of atopy (O.R.: 5,29, 95% CI: 1,22-25,57) ;(ii) absence of symptomatic household members (O.R.: 5,29, 95% CI: 1,72-16,27); (iii) presentation to dermatologists rather than other specialties (O.R.: 6,08, 95% CI: 1,9-19,51); whereas use of permethrin negatively affected treatment success (O.R: 0,22, 95% CI: 0,07-0,71). Conclusions: Pediatric scabies patients should be treated before other family members get affected and with topicals other than permethrin. Awareness of scabies disease needs to be increased among non-dermatologists.

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Section: Discussionmentioning

confidence: 71%

Factors Affecting Topical Treatment Success in Pediatric Scabies Cases: A Cross-Sectional Study

Oba,

Özkoca,

Başara Şahin

et al. 2023

Dermatol Pract Concept

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“…It is important to consider drug resistance or the involvement of "unusual" sites such as the periungual area or the scalp, when recalcitrant scabies is suspected. Although there are limited studies on the safety and efficacy of topical ivermectin 1% cream for classic scabies in adults, successful treatment has been reported in a few infants [ 2 ].…”

Section: Teaching Pointmentioning

confidence: 99%

Topical Ivermectin for Permethrin-Resistant Scabies: A Useful Application

Gnesotto,

Cutrone,

Mazzatenta

et al. 2024

Dermatol Pract Concept

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“…Dear Editor, In recent times, some articles have reported the emergence of Sarcoptes scabiei var. hominis resistance to permethrin [1]. We present our experience acquired in recent years in African patients with scabies.…”

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confidence: 97%

Pseudoresistance to permethrin in scabies

Veraldi,

Schianchi,

Silvio

et al. 2023

J Infect Dev Ctries

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Reports of permethrin resistance of Sarcoptes scabiei var. hominis are emerging. We propose that this may be pseudoresistance. The resistance is due to inadequate counselling by physicians, incorrect treatment (insufficient quantity of permethrin; too short length of treatment), and poor adherence and compliance by patients. Other reasons include single application of permethrin, suggestion to apply the drug for 6-8 hours, failed application on subungual folds, irritant contact dermatitis, in particular on genitals, for which some patients stop the treatment, and unexplainable use of permethrin in post-scabies prurigo. Thus, we believe that several cases of resistance to permethrin are actually cases of pseudoresistance.

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Topical ivermectin: an off‐label alternative to treat neonatal Scabies in the era of permethrin resistance

Cited by 11 publications

References 9 publications

Factors Affecting Topical Treatment Success in Pediatric Scabies Cases: A Cross-Sectional Study

Factors Affecting Topical Treatment Success in Pediatric Scabies Cases: A Cross-Sectional Study

Topical Ivermectin for Permethrin-Resistant Scabies: A Useful Application

Pseudoresistance to permethrin in scabies

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