S E Huffam1, B J Currie. 1. Royal Darwin Hospital, Menzies School of Health Research, Darwin, Northern Territory, Australia.
Abstract
OBJECTIVES: Crusted (Norwegian) scabies is an unusual variant of scabies caused by hyperinfestation with Sarcoptes scabiei. It has high morbidity, and secondary bacterial skin sepsis may result in life-threatening bacteremia. An open label study of oral ivermectin was carried out in patients with crusted scabies refractory to topical therapy. METHODS: Patients with refractory crusted scabies were prescribed oral ivermectin, one to three doses of 200 mg/kg at 14-day intervals, combined with topical scabicide and keratolytic therapy. RESULTS: Of the 20 patients who received ivermectin, 8 had a complete initial clinical response, a partial response was achieved in 9, and minimal improvement occurred in 3. Three doses of ivermectin were curative for 8 of 10 cases, but recurrence of scabies from presumed reinfestation occurred in at least half of these. CONCLUSION: The authors conclude that ivermectin is effective for crusted scabies; however, multiple doses may be required to achieve a cure, and recurrence 6 or more weeks after completing treatment is common.
OBJECTIVES: Crusted (Norwegian) scabies is an unusual variant of scabies caused by hyperinfestation with Sarcoptes scabiei. It has high morbidity, and secondary bacterial skin sepsis may result in life-threatening bacteremia. An open label study of oral ivermectin was carried out in patients with crusted scabies refractory to topical therapy. METHODS:Patients with refractory crusted scabies were prescribed oral ivermectin, one to three doses of 200 mg/kg at 14-day intervals, combined with topical scabicide and keratolytic therapy. RESULTS: Of the 20 patients who received ivermectin, 8 had a complete initial clinical response, a partial response was achieved in 9, and minimal improvement occurred in 3. Three doses of ivermectin were curative for 8 of 10 cases, but recurrence of scabies from presumed reinfestation occurred in at least half of these. CONCLUSION: The authors conclude that ivermectin is effective for crusted scabies; however, multiple doses may be required to achieve a cure, and recurrence 6 or more weeks after completing treatment is common.
Authors: M J Lydeamore; P T Campbell; W Cuningham; R M Andrews; T Kearns; D Clucas; R Gundjirryirr Dhurrkay; J Carapetis; S Y C Tong; J M McCaw; J McVernon Journal: Epidemiol Infect Date: 2018-05-08 Impact factor: 4.434
Authors: Jackson Thomas; Greg M Peterson; Shelley F Walton; Christine F Carson; Mark Naunton; Kavya E Baby Journal: BMC Infect Dis Date: 2015-07-01 Impact factor: 3.090
Authors: Thérèse M Kearns; Richard Speare; Allen C Cheng; James McCarthy; Jonathan R Carapetis; Deborah C Holt; Bart J Currie; Wendy Page; Jennifer Shield; Roslyn Gundjirryirr; Leanne Bundhala; Eddie Mulholland; Mark Chatfield; Ross M Andrews Journal: PLoS Negl Trop Dis Date: 2015-10-30