TY - JOUR
T1 - Comparison of topical permethrin 5% vs. benzyl benzoate 25% treatment in scabies: a double-blinded randomized controlled trial
AU - Meyersburg, Damian
AU - Hoellwerth, Magdalena
AU - Brandlmaier, Matthias
AU - Handisurya, Allesandra
AU - Kaiser, Andreas
AU - Prodinger, Christine
AU - Bauer, Johann W
N1 - Meyersburg, Hoellwerth, Brandlmaier, Prodinger, Bauer: Department of Dermatology and Allergology, University Hospital Salzburg of the Paracelsus Medical University Salzburg, Austria; Kaiser:Department of Psychosomatics and Inpatient Psychotherapy, University Hospital of Psychiatry and Psychotherapy, Paracelsus Medical University, Salzburg, Austria
PY - 2024/3/15
Y1 - 2024/3/15
N2 - BACKGROUND: Scabies is a pruritic, parasitic infestation of the skin. Increasing incidence has been reported from high income countries in the past years. Reports have indicated a reduction in the sensitivity of scabies mites to the standard treatment of choice, topical 5% permethrin.OBJECTIVES: First, to evaluate the head-to-head efficacy of two topical scabicides, 5% permethrin and 25% benzyl benzoate (BB), in the treatment of scabies using the same administration modality. Second, to address potential confounding factors, like incorrectly performed treatment and hygiene measures.METHODS: In total, 110 patients with dermoscopy-verified scabies infestation were enrolled and double-blinded randomized into two equally sized groups. 55 patients received topical 5% permethrin and 55 patients received topical 25% BB, both for daily use over a period of three consecutive days. Treatment outcome was evaluated by dermoscopy at a 3-week follow-up visit.RESULTS: Treatment resulted in a dermoscopy-verified cure rate of 27% in the permethrin group and 87% in the BB group. Tolerability and safety profile of 5% permethrin cream was excellent, while BB emulsion produced burning sensations in 24%.LIMITIATIONS: Single center study recruitment.CONCLUSION: Topical permethrin demonstrated a lack of efficacy in the majority of cases whereas benzyl benzoate demonstrated an excellent cure rate and reasonable tolerability. Considering the reduced sensitivity of scabies mites to 5% permethrin, our results suggest that benzyl benzoate is an appropriate first-line therapy in the treatment of scabies.TRIAL REGISTRATION: drks.de, ID DRKS00031062.
AB - BACKGROUND: Scabies is a pruritic, parasitic infestation of the skin. Increasing incidence has been reported from high income countries in the past years. Reports have indicated a reduction in the sensitivity of scabies mites to the standard treatment of choice, topical 5% permethrin.OBJECTIVES: First, to evaluate the head-to-head efficacy of two topical scabicides, 5% permethrin and 25% benzyl benzoate (BB), in the treatment of scabies using the same administration modality. Second, to address potential confounding factors, like incorrectly performed treatment and hygiene measures.METHODS: In total, 110 patients with dermoscopy-verified scabies infestation were enrolled and double-blinded randomized into two equally sized groups. 55 patients received topical 5% permethrin and 55 patients received topical 25% BB, both for daily use over a period of three consecutive days. Treatment outcome was evaluated by dermoscopy at a 3-week follow-up visit.RESULTS: Treatment resulted in a dermoscopy-verified cure rate of 27% in the permethrin group and 87% in the BB group. Tolerability and safety profile of 5% permethrin cream was excellent, while BB emulsion produced burning sensations in 24%.LIMITIATIONS: Single center study recruitment.CONCLUSION: Topical permethrin demonstrated a lack of efficacy in the majority of cases whereas benzyl benzoate demonstrated an excellent cure rate and reasonable tolerability. Considering the reduced sensitivity of scabies mites to 5% permethrin, our results suggest that benzyl benzoate is an appropriate first-line therapy in the treatment of scabies.TRIAL REGISTRATION: drks.de, ID DRKS00031062.
KW - Management
KW - Diagnosis
UR - https://www.webofscience.com/api/gateway?GWVersion=2&SrcApp=pmu_pure&SrcAuth=WosAPI&KeyUT=WOS:001148049900001&DestLinkType=FullRecord&DestApp=WOS_CPL
U2 - 10.1093/bjd/ljad501
DO - 10.1093/bjd/ljad501
M3 - Original Article
C2 - 38112640
SN - 0007-0963
VL - 190
SP - 486
EP - 491
JO - BRITISH JOURNAL OF DERMATOLOGY
JF - BRITISH JOURNAL OF DERMATOLOGY
IS - 4
ER -