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Treatment of scabies with albendazole

Letter to Dermatology
Benzimidazoles (albendazole, fenbendazole, oxfenbendazole, mebendazole, thiabendazole) are broad antiparasitic agents used Treatment of Scabies with Albendazole
against a wide range of nematodes and cestodes. By binding to free ␤ -tubulin, benzimidazoles inhibit the polymerization of tu- bulin and the microtubule-dependant glucose uptake, leading to Université Saint-Joseph, Hôtel-Dieu de France, Beirut , Lebanon parasitic death. These agents may additionally interfere with the synaptic transmission of parasites through a probable cholinergic effect [2] . Effectiveness of oral and topical thiabendazole against scabies has been pointed out in few reports since the 1960s [3, 4], and thiabendazole and the newer agent albendazole have been successfully used against pediculosis capitis [2, 5] ; yet little atten- Scabies is a highly communicable disease caused by infesta- tion has been paid to the antiscabies properties of benzimidazoles, tion with Sarcoptes scabiei var. hominis . Current treatments for given the limited experience with these drugs in this setting. Our scabies include benzyl benzoate, malathion, lindane and perme- observations represent, to our knowledge, the first cases of scabies thrin in addition to ivermectin [1] . The latter represents the only successfully treated with oral albendazole and suggest that this approved oral treatment for scabies and the therapeutic option for agent provides a potential therapeutic option for scabies. Further community-based treatment. Scabies outbreaks remain a serious evaluation of the effectiveness of albendazole against scabies is public health issue in Lebanon, and the failures of topical treat- ment modalities prove challenging to manage, given the unavail-ability of ivermectin in our country. We report 2 patients with scabies who were successfully treated with oral albendazole.
1 Chosidow O: Clinical practises. Scabies. N Engl J Med 2006; 354: 1718– 2 Namazi MR: Treatment of pediculosis capitis with thiabendazole: a Case 1. A 63-year-old woman presented clinical evidence of pilot study. Int J Dermatol 2003; 42: 973–976. 3 Hernandez-Perez E: Topically applied thiabendazole in the treatment crusted scabies. Diagnosis was ascertained by skin scrapings pos- of scabies. Arch Dermatol 1976; 112: 1400–1401. itive for S. scabiei . Several head-to-toe applications of benzyl ben- 4 Allegre T, Cailleres S, Lota I, et al: Value of thiabendazole in scabies zoate and lindane had been ineffective 2 months earlier. The pa- resistant to local treatment in HIV infected patients. Presse Med 1992; tient was prescribed a daily dose of 1,000 mg of albendazole with fatty meals for 3 consecutive days and an application of a 5% sal- 5 Akisu C, Delibas SB, Aksoy U: Albendazole: single or combination icylic acid ointment once daily for 1 week. The pruritus disap- therapy with permethrin against pediculosis capitis. Pediatr Dermatol peared within 5 days. Skin scrapings performed at the 1-week con- trol visit on residual skin lesions did not reveal any Sarcoptes mites. Lesions disappeared completely within 10 days. No side ef- fects or recurrence were observed during 3 months of follow-up.
Université Saint-Joseph , Hôtel-Dieu de France Case 2. A 76-year-old man with Alzheimer’s disease who had PO Box 16 - 6830, Achrafieh, Beirut (Lebanon) previously been treated with topical benzyl benzoate and per- Tel. +961 3 664 604, Fax +961 1 616 160, E-Mail methrin had extensive scabies. Skin scraping revealed live Sarcop-tes . The patient was administered 3 daily doses of 1,000 mg of albendazole along with fatty meals. Skin lesions disappeared within 1 week. No recurrence was observed during the 2 months of follow-up.
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