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Abstract
Scabies is a reemerging infection of the new millennium especially with the pandemic of HIV infection and it is still a major public health problem in developing countries.
Immunity to scabies mites involved mainly a cell-mediated immune response but scabies is also associated with a humoral immunological response.
Nocturnal pruritus is the chief symptom. The pathognomonic lesion of scabies is the burrow, but papules, vesicles, pustules, and other lesions are also present.
Clinical forms of scabies other than classic form include scabies in infants, scabies in elderly, scabies in bedridden, scabies incognito, scabies in clean, bullous scabies, animal scabies, nodular scabies and crusted scabies.
Current antiscabetics are mainly topical and sometimes require repeated applications. Resistance to some of these drugs has been developed.
Ivermectin is a broad spectrum antihelminthic that has been used for years in veterinary medicine for the treatment of both worms and ectoparasites. Ivermectin is safe in humans because it does not cross blood brain barrier. Oral Ivermectin offers several advantages over topical scabicides. It is easy, quick, safe, and well tolerated, with maximal patient compliance. It also avoids confusion between the persistence of scabies and dermatitis induced by topical scabicides.
We also found no correlation between severity of the disease and the number of doses given, but we observed that the longer the duration of the disease, the lesser is the response to treatment (negative correlation).
It could be concluded that oral ivermectin is an effective treatment for scabies, particularly when two doses are used. We recommend to use ivermectin as a first line therapy for epidemic scabies and scabies in institutions. We also deduce to use ivermectin for crusted scabies, either alone or combined with topical scabicides and for cases of ordinary scabies refractory to conventional topical antiscabetics. Further studies are needed to define clearly the place of ivermectin in the treatment of scabies.