Improvement in severe onchocercal skin disease after a single dose of ivermectin.
OBJECTIVE
Skin disease is the most common clinically important manifestation of onchocerciasis. Ivermectin, a newly available drug, is well tolerated and effective in Onchocerca volvulus infection. However, little information is available regarding its effect on onchocercal skin disease. The purpose of this study was to examine, in patients with well-characterized onchodermatitis, the effect of a single dose of ivermectin.


METHODS
Twenty-one persons with severe onchodermatitis were followed over a 6-month period. In order to evaluate the effect of ivermectin on their skin lesions, photographic transparencies were made before treatment and at 3 and 6 months after treatment. These were then evaluated in a blinded fashion.


RESULTS
Following a single dose of 150 micrograms/kg, there was a significant improvement in dermatitis in the first 3 months after treatment. All 14 persons with the worst skin disease showed improvement. The drug had no demonstrable effect on depigmented lesions over the period of observation. Treatment was well tolerated.


CONCLUSIONS
Single-dose ivermectin shows promise as the first acceptable treatment for severe onchocercal dermatitis.
Pacqué
M
M
Dana Center for Preventive Ophthalmology, Wilmer Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Elmets
C
C
Dukuly
Z D
ZD
Muñoz
B
B
White
A T
AT
Taylor
H R
HR
Greene
B M
BM
D000293:Adolescent; D000328:Adult; D000368:Aged; D000977:Antiparasitic Agents; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007559:Ivermectin / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D007988:Liberia / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009855:Onchocerciasis / Q000188:drug therapy* / Q000453:epidemiology / Q000473:pathology; D012876:Skin Diseases, Parasitic / Q000453:epidemiology / Q000473:pathology
D000977:Antiparasitic Agents; D007559:Ivermectin