Comparative Efficacy of Topical Pertmehrin, Crotamiton and Sulfur Oint-ment in Treatment of Scabies
AbstractBackground: Scabies is an ectoparasitic infection, which occurs because of direct skin-to skin contact. The ideal treatment modality is still unclear and further research on this topic is warranted. The aim of the study was to compare the efficacy and safety of the topical scabicides: permethrin, crotamiton and sulfur ointment.Methods: Fifty four patients with diagnosed scabies were randomly divided into three treatment groups. The first group received 5% permethrin cream twice with one week interval, the patients from the second group were given crotamiton lotion for two days twice with one week interval, while the third group received 10% sulfur ointment for two or three weeks. All patients were followed up at 1, 2 and 4 weeks intervals.Results: At one-week follow up the cure rate was significantly higher at permethrin-treated group when compared to crotamiton group (P< 0.001) and sulfur group (P< 0.001). At the end of two-week interval, the cure rate at permethrin group was 100%, while at crotamiton group, 66.7% and in sulfur group 38.9% (P< 0.001). At 4-week follow up the applied treatment was effective in all studied individuals.Conclusion: The topical application of permethrin, crotamiton and sulfur was equally efficacious at 4-week follow up, however permethrin cream showed faster improvement at first and second follow up. Acquiring permethrin is considered as expensive option and crotamiton lotion seems to be cost-less alternative to this cream.
Abedin S, Narang M, Gandhi V, Narang S (2007) Efficacy of permethrin cream and oral ivermectin in treatment of scabies. Indian J Pediatr. 74(10): 915–916.
Andrews RM, McCarthy J, Carapetis JR, Currie DJ (2009) Skin disorders, in- cluding pyoderma, scabies, and tinea infections. Pediatr Clin N Am. 56:1421–1440.
Arif Maan MA, Arif Maan MS, Sohail AM,Afif M (2015) Bullous scabies: a case report and review of the literature. BMC Res Notes. 8: 254–257.
Bachewar NT, Thawani VR, Mali SN, Gharpure KJ, Shingade VP, Dakhale GN (2009) Comparison of safety, effi- cacy, and cost effectiveness of benzyl benzoate, permethrin, and ivermectin in patients with scabies. Indian J Phar- macol. 41: 9–14.
Chhaiya SB, Patel VJ, Dave JN, Mehta DS, Shah HA (2012) Comparative efficacy and safety of topical permethrin, topi- cal ivermectin, and oral ivermectin in patients of uncomplicated scabies. In- dian J Dermatol Venerol Leprol. 78:605–610.
Chosidow O (2012) Clinical practices. Scabies.N Engl J Med. 354(16): 1718–1727. Fukuyama S, Nishimura T, Yotsumoto H,Gushi A, Tsuji M, Kanekura T, Ma- tsuyama T (2010) Diagnosis usefulness of a nested polymerase chain reaction assay for detecting Sarcoptes scabiei DNA in skin scrapings from clinically suspected scabies. Br J Dermatol. 163:875–899.
Golant AK, Levitt JO (2012) Scabies: a re- view of diagnosis and management based on mite biology. Pediatr Rev.33(1): e1–e12.
Goldust M, Rezaee E, Raghifar R, Naghavi- Behzad M (2013a) Ivermectin vs. lin- dane in the treatment of scabies. Ann Parasitol. 59(1): 37–41.
Goldust M, Rezaee E, Raghifar R, Hemayat S (2013b) Treatment of scabies: the topical ivermectin vs. permethrin 2.5% cream. Ann Parasitol. 59(2): 79–84.
Goldust M, Rezaee E, Raghifar R, Naghavi- Behzad M (2013c) Comparison of per- methrin 2.5% cream vs. Teutex emul- sion for the treatment of scabies. Ann Parasitol. 59(1): 31–35.
Goldust M, Rezaee E, Raghifar R (2014) Comparison of oral ivermectin versus crotamiton 10% cream in the treatment of scabies. Cutan Ocul Toxicol. 33(4):333–336.
Karthikeyan K (2005) Treatment of scabies:newer perspectives. Postgrad Med J.81: 7–11.
McLean FE (2013) The elimination of sca- bies: a task for our generation. Int J Dermatol. 52: 1215–1223.
Meinking TL (1999) Infestations. Curr Probl Dermatol. 11: 80–103.
Miyajima A, Komoda M, Akagi K, Yuzawa K, Yoshimasu T, Yamamoto Y, Hirota T (2015) Experimental study of phar- macokinetics of external, whole-body bathing application of ivermectin. J Dermatol. 42: 87–89.
Mohebbipour A, Saleh P, Goldust M, Amir- nia M, Zadeh YJ, Mohamad RM, Re- zaee E (2013) Comparision of oral ivermectin vs. lindane lotion 1% for the treatment of scabies. Clin Exp Dermatol. 38: 719–723.
Mounsey KE, McCarthy JS (2013) Treat- ment and control of scabies. Curr Opin Infect Dis. 26: 133–139.
Oberoi S, Ahmed RS, Suke SG, Bhattachar-ya SN, Chakraborti A, Banerjee BD (2007) Comparative effect of topical application of lindane and permethrin on oxidative stress parameters in adult scabies patients. Clin Biochem. 40:1321–1324.
Park JH, Kim CW, Kim SS (2012) The di- agnostic accuracy of dermoscopy for scabies. Ann Dermatol. 24(2): 194–199.
Panahi Y, Poursaleh Z, Goldust M (2015) The efficacy of topical and oral iver- mectin in the treatment of human sca- bies. Ann Parasitol. 61(1): 11–16.
Pourhasan A, Goldust M, Rezaee E (2013) Treatment of scabies, permethrin 5% vs. crotamiton 10% cream. Ann Para- sitol. 59(3): 143–147.
Rampton M, Walton SF, Holt DC, Pasay C, Kelly A, Currie BL, McCarthy JS,Mounsey KE (2013) Antibody respons- es to Sarcoptes scabiei apolipoprotein in a porcine model:relevance to immunodiagnosis of recent in- fection. PLOS One 8(6): e65354.
Ranjkesh MR, Naghili B, Goldust M, Rezaee E (2013) The efficacy of permethrin 5% vs. oral ivermectin for the treat- ment of scabies. Ann Parasitol. 59(4):189–194.
Romani L, Steer AC, Whitfeld MJ, Kaldor JM (2015) Prevelence of scabies and im- petigo worldwide: a systematic review. Lancet Infect Dis. 15(8): 960–967.
Roos TC, Alam M, Roos S, Merk HF, Bick- ers DR (2001) Pharmacotherapy of ec- toparasitic infections. Drugs. 61: 1067–1088.
Sharma R, Singal A (2011) Topical perme- thrin and oral ivermectin in the man- agement of scabies: a prospective, ran- domized, double blind, controlled study. Indian J Dermatol Venerol Leprol. 77:581–586.
Sharquie KE, Al-Rawi JR, Noaimi AA, Al- Hassany HM (2012) Treatment of sca- bies using 8% and 10% topical sulfur ointment in different regimens of ap- plication. J Drugs Dermatol. 11(3): 357–364.
Shimose L, Munoz-Prize S (2013) Diagno- sis, prevention, and treatment of sca- bies. Curr Infect Dis Rep. 15: 426–431.
Strong M, Johnstone P (2007) Interventions for treating scabies. Cochrane Database Syst Rev. 3: CD000320.
Taplin D, Meinking TL (1988) Infestations. In: Schechner LA, Hansen RC (Eds): Pe- diatric dermatology. Vol. 2. Churchill Livingstone, New York, pp. 1465–1516.
Taplin D, Meinking TL, Chen JA, Sanchez R (1990) Comparison of crotamiton 10% cream (Eurax) and permethrin 5% cream (Elimite) for treatment of sca- bies in children. Pediatr Dermatol. 7 (1): 67–73.
Thomas J, Pterson GM, Walton SF, Carson CF, Naunton M, Baby KE (2015) Sca- bies: an ancient global disease with a need for new therapies. BMC Infect Dis. 15: 250–255.
Usha V, Gopalakrishnan Nair TV (2000) A comparative study of oral ivermectin and topical permethrin cream in treat- ment of scabies. J Am Acad Dermatol. 42(2): 236–240.