Gladstone H B, Darmstadt G L
Division of Dermatology, Department of Medicine, Children's Hospital and Regional Medical Center, University of Washington School of Medicine, Seattle, Washington 98105, USA.
Pediatr Dermatol. 2000 Mar-Apr;17(2):144-8. doi: 10.1046/j.1525-1470.2000.01736.x.
An 11-year-old girl presented to our clinic with recalcitrant crusted scabies despite repeated applications of topical scabicides. She had no history of corticosteroid use prior to onset of the eruption and no evidence of immunodeficiency. A combination of oral ivermectin, topical lindane, and keratolytics cleared the infestation. Our patient is exceptional in that she had no risk factors commonly associated with a propensity to develop crusted scabies. While topical therapy remains the first-line treatment for children with classic scabies, in the unusual instance of a child with recalcitrant, crusted scabies, ivermectin may offer an efficacious alternative, although it should be used with caution. We discuss the use of oral ivermectin for treatment of crusted scabies and the challenging comprehensive management needed for this socially stigmatizing condition.
一名11岁女孩因尽管反复外用杀疥剂但仍患有顽固性结痂性疥疮前来我们诊所就诊。在皮疹发作前她没有使用皮质类固醇的病史，也没有免疫缺陷的证据。口服伊维菌素、外用林丹和角质剥脱剂联合使用清除了感染。我们的患者很特殊，因为她没有通常与易患结痂性疥疮相关的危险因素。虽然局部治疗仍然是经典疥疮患儿的一线治疗方法，但在患有顽固性结痂性疥疮的儿童这种不寻常的情况下，伊维菌素可能是一种有效的替代方法，尽管应谨慎使用。我们讨论了口服伊维菌素治疗结痂性疥疮的用法以及这种具有社会污名化的疾病所需的具有挑战性的综合管理。
