Sulfur vs. Different Regimes of Permethrin for Scabies

Summary

In 2017, the World Health Organization (WHO) labeled scabies as a neglected tropical disease. It is a serious health problem especially in poor developing countries like Syria, where overcrowding, poverty, and war consequences are considered major factors for spreading the disease. Permethrin lotion or cream is the treatment of choice for scabies, and it is applied once a week for two consecutive weeks according to the global guidelines. However, most practitioners in Syria do not adhere to this standard regimen, and a variety of regimens are used instead based mostly on clinical experience. In this study, the investigators are comparing four different regimens of permethrin application and comparing Sulfur to permethrin in terms of efficacy and safety.

Timeline

Start

2022-03-15

Primary completion

2022-09-15

Completion

2022-11-12

Publications

• Background Walton SF, Currie BJ. Problems in diagnosing scabies, a global disease in human and animal populations. Clin Microbiol Rev. 2007 Apr;20(2):268-79. doi: 10.1128/CMR.00042-06.
• Background Hay RJ, Steer AC, Engelman D, Walton S. Scabies in the developing world--its prevalence, complications, and management. Clin Microbiol Infect. 2012 Apr;18(4):313-23. doi: 10.1111/j.1469-0691.2012.03798.x.
• Background Fuller LC. Epidemiology of scabies. Curr Opin Infect Dis. 2013 Apr;26(2):123-6. doi: 10.1097/QCO.0b013e32835eb851.
• Background Strong M, Johnstone P. Interventions for treating scabies. Cochrane Database Syst Rev. 2007 Jul 18;2007(3):CD000320. doi: 10.1002/14651858.CD000320.pub2.
• Background Khalil S, Abbas O, Kibbi AG, Kurban M. Scabies in the age of increasing drug resistance. PLoS Negl Trop Dis. 2017 Nov 30;11(11):e0005920. doi: 10.1371/journal.pntd.0005920. eCollection 2017 Nov.
• Background Karthikeyan K. Treatment of scabies: newer perspectives. Postgrad Med J. 2005 Jan;81(951):7-11. doi: 10.1136/pgmj.2003.018390.
• Background Avila-Romay A, Alvarez-Franco M, Ruiz-Maldonado R. Therapeutic efficacy, secondary effects, and patient acceptability of 10% sulfur in either pork fat or cold cream for the treatment of scabies. Pediatr Dermatol. 1991 Mar;8(1):64-6. doi: 10.1111/j.1525-1470.1991.tb00844.x.
• Background Chosidow O. Scabies and pediculosis. Lancet. 2000 Mar 4;355(9206):819-26. doi: 10.1016/s0140-6736(99)09458-1.
• Background Rosumeck S, Nast A, Dressler C. Ivermectin and permethrin for treating scabies. Cochrane Database Syst Rev. 2018 Apr 2;4(4):CD012994. doi: 10.1002/14651858.CD012994.
• Background Engelman D, Yoshizumi J, Hay RJ, Osti M, Micali G, Norton S, Walton S, Boralevi F, Bernigaud C, Bowen AC, Chang AY, Chosidow O, Estrada-Chavez G, Feldmeier H, Ishii N, Lacarrubba F, Mahe A, Maurer T, Mahdi MMA, Murdoch ME, Pariser D, Nair PA, Rehmus W, Romani L, Tilakaratne D, Tuicakau M, Walker SL, Wanat KA, Whitfeld MJ, Yotsu RR, Steer AC, Fuller LC. The 2020 International Alliance for the Control of Scabies Consensus Criteria for the Diagnosis of Scabies. Br J Dermatol. 2020 Nov;183(5):808-820. doi: 10.1111/bjd.18943. Epub 2020 Mar 29.
• Background Sharma R, Singal A. Topical permethrin and oral ivermectin in the management of scabies: a prospective, randomized, double blind, controlled study. Indian J Dermatol Venereol Leprol. 2011 Sep-Oct;77(5):581-6. doi: 10.4103/0378-6323.84063.

Drugs

Indications