[Scabies therapy in Germany : Results of a nationwide survey with a special focus on the efficacy of first-line therapy with permethrin]. / Skabiestherapie in Deutschland : Ergebnisse einer bundesweiten Umfrage mit besonderem Fokus auf die Wirksamkeit der Erstlinientherapie mit Permethrin.

BACKGROUND: According to the current scabies guideline, topical treatment with permethrin 5% cream is the first-line therapy of common scabies in Germany. However, in the course of growing incidence of scabies in recent years there have been increasing numbers of reports of reduced efficacy in standard therapy. OBJECTIVE: To establish a better understanding for the efficacy of scabies therapy under practice conditions, a survey focusing on the first-line therapy with permethrin was conducted in dermatological hospitals, outpatient clinics and dermatology practices. METHODS: The postal survey addressed all dermatologically active physicians in Germany and queried diagnostic methods, the individual initial treatment, the estimated efficacy of permethrin therapy, the frequency and reasons for therapy failures under permethrin and the therapeutic approach in case of failure of the initial therapy. RESULTS: The efficacy of permethrin was rated with 73% by 187 physicians. About 74% reported to treat initially with 5% permethrin cream. The most common reasons identified for treatment failure were application errors, lack of compliance and inadequate hygiene measures. Suspected diminished efficacy or development of resistance against permethrin and re-infestations were also mentioned. In the case of ineffectiveness of initial therapy, most clinicians opt for oral ivermectin, a repetition of permethrin therapy or a combination of both. CONCLUSION: Although there are localized reports of decreased effectiveness of permethrin therapy, results of this survey point towards a persisting high efficacy of first-line standard treatment of scabies with permethrin 5% cream in Germany.

Nerve conduction study of ulnar nerve in volleyball players.

Ulnar neuropathy at the elbow is a common disorder seen in the throwing athlete. The purpose of our study was to determine whether asymptomatic physically active volleyball players and non-actives demonstrate distinct differences in nerve conduction of the ulnar nerve at the elbow. Nerve conduction studies were performed on both arms of 24 male volleyball players and 24 male non-actives. Nerve conduction velocity at the above to below elbow segment of the ulnar motor nerve were slower in the volleyball players compared with controls and their non-dominant arms. There were no statistical differences in latencies and conduction velocity of the ulnar nerve on the forearm, both in volleyball players and in the controls. In the evoked responses of the ulnar nerve, the amplitude was the same as corresponding normal values in both sensory nerve and muscle action potentials. We conclude that abnormal ulnar (motor) nerve conduction at the elbow segment may suggest a subclinical entrapment neuropathy as a result of strenuous elbow movements in volleyball players.

Carpal tunnel syndrome in carpet weavers.

We examined the prevalence of abnormal median nerve conduction within the carpal tunnel in carpet weavers. Nerve Conduction Studies (NCS) were performed on both hands of 47 subjects. Subjects had worked previously for an average of 8.4 (range 6-21) years and a mean age of 34.8 (17-55) years. An abnormal median nerve latencies and, symptoms associated with carpal tunnel syndrome (CTS) were found 10 (21.2%) and 2 (4.2%) in the subjects studied, respectively. We conclude that the high prevalence of abnormal median nerve conduction without corresponding symptoms, may suggest a subclinical entity associated with CTS.