Darge K, Büttner D W
Department of Helminthology, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany.
Trop Med Parasitol. 1995 Dec;46(4):206-12.
Seventeen male and 39 female Liberian patients, one third of them children, were diagnosed as having hyperreactive onchodermatitis (sowda). They presented with itching (98%), asymmetric (98%), chronic onchodermatitis (median 5 years), and swelling of femoral lymph nodes (89%). The geometric means of the microfilaria (mf) densities were 1.0 mf/mg in children and 0.7 mf/mg in adults. These patients not only suffered from their skin lesions, and severe itching resulting in disturbance of sleep but also from social stigmata. They urgently needed treatment. Ivermectin was administered as a single oral dose of 150 micrograms/kg body weight. The following adverse effects were observed in 30 patients within the first 72 hours after ivermectin treatment: increase of pruritus (93%), aggravation of dermatitis (73%), fever (25%), headache (20%), myalgia (20%), painful swelling of lymph nodes (13%) and severe swelling of arm or leg (10%). Symptomatic therapy was sufficient. No dangerous or life-threatening side effects were observed. At follow-up examinations 1-2 months after ivermectin treatment, the prevalence of mf carriers had decreased from 100% to 19%. Seventeen out of 18 patients felt their dermatitis had improved. Evaluation of the dermatitis by a physician using a score from 0 (no dermatitis) to 9 (severe dermatitis) revealed a reduction of the score from 4.3 before treatment to 0.7 (84%) after ivermectin. In contrary, at the follow-up examination of 16 patients 6-12 months after ivermectin some recrudescences were observed. In this group the prevalence of mf carriers was 47%, 13 out of the 16 patients felt their skin lesions had improved and the score had decreased from 2.2 to 0.5 (77%). Consequently, it is recommended to administer ivermectin to patients with hyperreactive onchodermatitis every 3-4 months.
17名男性和39名女性利比里亚患者被诊断患有高反应性盘尾丝虫性皮炎（sowda），其中三分之一为儿童。他们表现出瘙痒（98%）、不对称（98%）、慢性盘尾丝虫性皮炎（中位病程5年）以及股淋巴结肿大（89%）。儿童微丝蚴（mf）密度的几何平均值为1.0 mf/mg，成人为0.7 mf/mg。这些患者不仅遭受皮肤损害和严重瘙痒导致睡眠障碍，还受到社会污名的影响。他们急需治疗。给予伊维菌素单剂量口服，剂量为150微克/千克体重。在伊维菌素治疗后的前72小时内，30名患者出现了以下不良反应：瘙痒加剧（93%）、皮炎加重（73%）、发热（25%）、头痛（20%）、肌痛（20%）、淋巴结疼痛性肿大（13%）以及手臂或腿部严重肿胀（10%）。对症治疗就足够了。未观察到危险或危及生命的副作用。在伊维菌素治疗后1至2个月的随访检查中，mf携带者的患病率从100%降至19%。18名患者中有17名感觉他们的皮炎有所改善。医生使用从0（无皮炎）到9（严重皮炎）的评分对皮炎进行评估，结果显示评分从治疗前的4.3降至伊维菌素治疗后的0.7（降低了84%）。相反，在伊维菌素治疗后6至12个月对16名患者的随访检查中，观察到了一些复发情况。在该组中，mf携带者的患病率为47%，16名患者中有13名感觉他们的皮肤损害有所改善，评分从2.2降至0.5（降低了77%）。因此，建议每3至4个月给高反应性盘尾丝虫性皮炎患者服用一次伊维菌素。
