Research & Innovation
Publications
Comparison of topical permethrin 5% vs. benzyl benzoate 25% treatment in scabies: a double-blinded randomized controlled trial
PMU Authors
Damian Meyersburg, Magdalena Hoellwerth, Matthias Brandlmaier, Andreas Kaiser, Christine Prodinger, Johann W Bauer
All Authors
Damian Meyersburg, Magdalena Hoellwerth, Matthias Brandlmaier, Allesandra Handisurya, Andreas Kaiser, Christine Prodinger, Johann W Bauer
Journal association
BRITISH JOURNAL OF DERMATOLOGY
Abstract
Background Scabies is a pruritic parasitic infestation of the skin. High-income countries have reported an increasing incidence over the last few years. Studies have indicated a reduction in the sensitivity of scabies mites to the standard treatment of choice, topical permethrin 5%.Objectives To evaluate in a head-to-head manner the efficacy of two topical scabicides [permethrin 5% and benzyl benzoate 25% (BB)] in the treatment of scabies using the same administration modality; and to address potential confounding factors such as incorrectly performed treatment and hygiene measures.Methods In total, 110 patients with dermoscopy-verified scabies infestation were enrolled and randomized into two equally sized groups in a double-blinded manner. Fifty-five received topical permethrin 5% and 55 received topical BB 25%, 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. The tolerability and safety profile of permethrin 5% cream was excellent, while the BB emulsion produced a burning sensation in 43% of patients.Conclusions Topical permethrin demonstrated a lack of efficacy in the majority of scabies cases, whereas BB demonstrated an excellent cure rate and reasonable tolerability. Considering the reduced sensitivity of scabies mites to permethrin 5%, our results suggest that BB is an appropriate first-line therapy in the treatment of scabies.In this single-centre randomized double-blinded prospective trial of 110 patients with scabies, we demonstrated a cure rate of 27% in the permethrin group and 87% in the benzyl benzoate group. Topical permethrin demonstrated a lack of efficacy in the majority of cases, whereas benzyl benzoate demonstrated an excellent cure rate and reasonable tolerability. Our results suggest that benzyl benzoate is an appropriate first-line agent in the treatment of scabies.
Keywords
MANAGEMENT, DIAGNOSIS