Comparison of the Efficacy and Safety of Topical Permethrin 5% Cream versus Topical Benzyl Benzoate 25% Lotion in Children with Scabies
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Introduction: Scabies is a highly contagious parasitic infestation predominantly affecting children in resource-limited settings. Both topical permethrin 5% cream and benzyl benzoate 25% lotion are used in clinical practice, yet comparative data in the pediatric population from local tertiary care settings remain limited. Objective: To compare the efficacy and safety of topical permethrin 5% cream with topical benzyl benzoate 25% lotion in children with scabies presenting to a tertiary care dermatology centre. Study Design: Quasi-experimental study. Setting: Department of Dermatology, Mayo Hospital, Lahore. Duration: 1st January 2024 to 31st December 2024. Subjects and Methods: A total of 150 children aged 3–14 years with clinically diagnosed scabies were enrolled and allocated by alternate assignment to two groups of 75 each. Group A received topical permethrin 5% cream and Group B received topical benzyl benzoate 25% lotion. Clinical cure rates, time to pruritus resolution, and local adverse effects were assessed at 2 and 4 weeks following the first application. Results: At 2 weeks, clinical cure was achieved in 68 (90.7%) patients in Group A compared with 54 (72.0%) in Group B (p=0.006). At 4 weeks, cure rates were 96.0% and 84.0% respectively (p=0.023). Mean time to pruritus resolution was significantly shorter in Group A (8.1 ± 2.3 days vs 11.9 ± 3.4 days, p<0.001). Any adverse effect was recorded in 20.0% of Group A versus 50.7% of Group B (p<0.001). Conclusion: Topical permethrin 5% cream demonstrated superior efficacy and a more favorable safety profile compared with benzyl benzoate 25% lotion in children with scabies and is recommended as the preferred first-line scabicidal agent in this population.
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1. Romani L, Steer AC, Whitfeld MJ, Kaldor JM. Prevalence of scabies and impetigo worldwide: a systematic review. Lancet Infect Dis. 2015;15(8):960-7. doi: 10.1016/S1473-3099(15)00132-2.
2. Chosidow O. Clinical practice. Scabies. N Engl J Med. 2006;354(16):1718-27. doi: 10.1056/NEJMcp052784.
3. Hay RJ, Steer AC, Engelman D, Walton S. Scabies in the developing world: its prevalence, complications, and management. Clin Microbiol Infect. 2012;18(4):313-23. doi: 10.1111/j.1469-0691.2012.03798.x.
4. Aamir AH, Ul-Haq Z, Mahar SA, Badar N, Ahmad I, Jafri SN. Prevalence of dermatological conditions among outpatient attendees in Pakistan. J Pak Med Assoc. 2010;60(3):223-7. DOI not available.
5. Steer AC, Jenney AW, Kado J, Batzloff MR, La Vincente S, Waqatakirewa L, et al. High burden of impetigo and scabies in a tropical country. PLoS Negl Trop Dis. 2009;3(6):e467. doi: 10.1371/journal.pntd.0000467.
6. Hengge UR, Currie BJ, Jäger G, Lupi O, Schwartz RA. Scabies: a ubiquitous neglected skin disease. Lancet Infect Dis. 2006;6(12):769-79. doi: 10.1016/S1473-3099(06)70654-5.
7. Mufti TA, Iqbal HZ, Nawazish A, Sajjad A, Priya S, Shaukat F, et al. Comparative analysis of clinical and metabolic profiles in ischemic versus hemorrhagic stroke among adults presenting to a tertiary care hospital. Cureus. 2025;17(8):e90245. doi: 10.7759/cureus.90245.
8. Strong M, Johnstone P. Interventions for treating scabies. Cochrane Database Syst Rev. 2007;(3):CD000320. doi: 10.1002/14651858.CD000320.pub2.
9. Usha V, Gopalakrishnan Nair TV. A comparative study of oral ivermectin and topical permethrin cream in the treatment of scabies. J Am Acad Dermatol. 2000;42(2 Pt 1):236-40. doi: 10.1016/S0190-9622(00)90131-2.
10. Bachewar NP, Thawani VR, Mali SN, Gharpure KJ, Shingade VP, Dakhale GN. Comparison of safety, efficacy, and cost effectiveness of benzyl benzoate, permethrin, and ivermectin in patients of scabies. Indian J Pharmacol. 2009;41(1):9-14. doi: 10.4103/0253-7613.48882.
11. Sharma R, Singal A. Topical permethrin and oral ivermectin in the management of scabies: a prospective, randomized, double blind, controlled study. Indian J Dermatol Venereol Leprol. 2011;77(5):581-6. doi: 10.4103/0378-6323.84063.
12. Chhaiya SB, Patel VJ, Dave JN, Mehta DS, Shah HA. Comparative efficacy and safety of topical permethrin, topical ivermectin, and oral ivermectin in patients of uncomplicated scabies. Indian J Dermatol Venereol Leprol. 2012;78(5):605-10. doi: 10.4103/0378-6323.100571.
13. Currie BJ, McCarthy JS. Permethrin and ivermectin for scabies. N Engl J Med. 2010;362(8):717-25. doi: 10.1056/NEJMct0910329.
14. Rauf A, Iqbal HZ, Zohaib M, Naeem M, Mufti TA, Sadique H, et al. Frequency of early microvascular changes in prediabetic individuals: a focus on renal, retinal, and peripheral nerve involvement. Cureus. 2025;17(9):e92040. doi: 10.7759/cureus.92040.
15. Walton SF, Currie BJ. Problems in diagnosing scabies, a global disease in human and animal populations. Clin Microbiol Rev. 2007;20(2):268-79. doi: 10.1128/CMR.00042-06.
16. Mounsey KE, McCarthy JS, Walton SF. Scratching the itch: new tools to advance understanding of scabies. Trends Parasitol. 2013;29(1):35-42. doi: 10.1016/j.pt.2012.09.006.
17. Thomas J, Peterson GM, Walton SF, Carson CF, Naunton M, Baby KE. Scabies: an ancient global disease with a need for new therapies. BMC Infect Dis. 2015;15:250. doi: 10.1186/s12879-015-0983-z.
18. Johnston G, Sladden M. Scabies: diagnosis and treatment. BMJ. 2005;331(7517):619-22. doi: 10.1136/bmj.331.7517.619.
19. Golant AK, Levitt JO. Scabies: a review of diagnosis and management based on mite biology. Pediatr Rev. 2012;33(1):e1-12. doi: 10.1542/pir.33-1-e1.
20. Abubakar M, Zahid A, Hoque T, Manoharan H, Naeem O, Muhammad I, et al. Predictors of 90-day re-hospitalization in heart failure: insights from a prospective observational study in a tertiary care setting. Cureus. 2025;17(11):e98187. doi: 10.7759/cureus.98187.
21. Park JH, Kim CW, Kim SS. The diagnostic accuracy of dermoscopy for scabies. Ann Dermatol. 2012;24(2):194-9. doi: 10.5021/ad.2012.24.2.194.
22. Burkhart CG, Burkhart CN, Burkhart KM. An epidemiologic and therapeutic reassessment of scabies. Cutis. 2000;65(4):233-40.