Ivermectin for Sarcoptes scabiei hyperinfestation.
OBJECTIVE
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.


CONCLUSIONS
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.
Huffam
S E
SE
Royal Darwin Hospital, Menzies School of Health Research, Darwin, Northern Territory, Australia.
Currie
B J
BJ
D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000818:Animals; D000977:Antiparasitic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001315:Australia; D005260:Female; D006801:Humans; D007559:Ivermectin / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D015876:Northern Territory; D012532:Scabies / Q000188:drug therapy*; D016896:Treatment Outcome
D000977:Antiparasitic Agents; D007559:Ivermectin