Treatment of Ectoparasitic Infections: Review of the English-Language Literature, 1982–1992

Abstract

We reviewed the English-language literature of 1982-1992 for papers concerning scabies, pediculosis, and their treatments; this information was supplemented with opinions of workers in the field of ectoparasitic disease. Six treatment trials for scabies, one study of the treatment of pediculosis pubis, and additional studies on the treatment of pediculosis capitis were included. Both lindane 1% and permethrin 5% are effective treatments for scabies, although resistance to lindane does exist. Lindane 1%, permethrin 1%, and pyrethrins with piperonyl butoxide are all effective treatments for pediculosis. Severe reactions to lindane therapy may occur when increased skin absorption of lindane occurs. Permethrin 5% or lindane 1% is recommended for the treatment of scabies. Lindane should be used with precautions to avoid excess skin penetration and should not be used to treat infants, young children, or pregnant or lactating women. Permethrin 1%, lindane 1%, or pyrethrins with piperonyl butoxide is recommended for the treatment of pediculosis pubis. Pregnant and lactating women should be treated with either permethrin or with pyrethrins containing piperonyl butoxide.

Ivermectin alone or in combination with benzyl benzoate in the treatment of human immunodeficiency virus-associated scabies

“…Ivermectin is an antihelminthic used widely in veterinary medicine for nematode, insect and acarine parasites, including Sarcoptes scabiei . 23 It has also been used world‐wide in humans for treating onchocerciasis, strongyloidiasis and other parasitic infestations 7,22 , 24 . There are several reports of its efficacy in human scabies, 3,5 , 7,23 including some detailing its use in crusted scabies in HIV‐positive/AIDS patients 1–4,8 .…”

Treatment of scabies infestations

“…5 % permethrin dermal cream is the treatment of choice (Schultz et al, 1990;Purvis et al, 1991;Paller, 1993;Brown et al, 1995;Usha et al, 2000;Buffet et al, 2003;Scheinfeld, 2004). It is important to S cabies is an intensely pruritic disorder induced by an immune allergic response to infestation of the skin by the mite Sarcoptes scabiei.…”

Current treatments for scabies

“…Isolated cases of failure suggest resistant mites [15,16]. This, in addition to its greater toxicity than 5% permethrin cream, makes lindane a second‐line treatment in the US.…”