An estimated 200 million people are affected worldwide. In 2017, the WHO formally designated scabies a neglected tropical disease and in 2020 integrated this condition into the WHO roadmap for neglected tropical diseases 2021–30, as part of the Sustainable Development Goals.
This double-blind RCT compared topical permethrin 5% with benzyl benzoate (BB) 25% for the treatment of dermoscopy-confirmed scabies, addressing concerns about emerging permethrin resistance. A total of 110 patients were randomized equally to receive either permethrin 5% cream or BB 25% emulsion, applied daily for three consecutive days using the same treatment protocol and hygiene measures. Cure was assessed objectively by dermoscopy at 3 weeks.
The results showed a marked difference in efficacy: cure rates were 27% with permethrin versus 87% with benzyl benzoate. Permethrin was very well tolerated, while BB caused a burning sensation in 43% of patients, but this was generally manageable. Despite lower tolerability, BB demonstrated substantially superior effectiveness.
Clinical implication: In settings where permethrin resistance is suspected, benzyl benzoate may be a more effective first-line option for scabies.
Comparison of topical permethrin 5% vs. benzyl benzoate 25% treatment in scabies: a double-blinded randomized controlled trial . Br J Dermatol. 2024 Mar 15;190(4):486-491. doi: 10.1093/bjd/ljad501. PMID: 38112640.
0 Comments