Efficacy of permethrin cream and oral ivermectin in treatment of scabies.

OBJECTIVE: To compare the efficacy of mass treatment of scabies with permethrin cream and oral ivermectin in a closed urban pediatric population. METHODS: A comparative trial of topical permethrin and oral ivermectin was conducted in a closed population of 84 children living in a urban hostel of Delhi. RESULTS: After mass treatment with 2 doses of oral ivermectin, one case was recorded in following 6 months, as compared to 22 cases in preceding 6 months when children were treated with a single application of 5% permethrin. CONCLUSION: Mass treatment of scabies with ivermectin in an endemic population is more efficacious as compared to topical permethrin application in reducing the baseline prevalence, decreasing the chain of transmission and chances of reinfection.

Dorfman-Chanarin syndrome.

A four-year-old girl was brought to the dermatology outpatient department with scaling all over the body since birth. She had history of episodic vomiting and abdominal distension. A dermatological diagnosis of lamellar ichthyosis was made. Abdominal examination revealed a nontender hepatomegaly, fatty liver on ultrasonography and deranged liver function tests. Peripheral blood smear showed lipid vacuoles in the granulocytes consistent with Jordans' anomaly. Similar lipid vacuoles were seen in the basal layer in skin biopsy. An inflammatory infiltrate, moderate fibrosis in the portal tract and diffuse severe fatty change in hepatocytes were seen in liver biopsy. The patient was diagnosed as a case of Dorfman-Chanarin syndrome.