2012 六月 日本期刊出現一篇來自伊朗關於疥瘡治療的文章http://onlinelibrary.wiley.com/doi/10.1111/j.1346-8138.2011.01481.x/references
這是一篇關於口服與外用治療對於scabies療效的臨床治療比較.
在台灣因為衛生條件較好,加上健保支持,讓疥瘡的問題一直停留在小部份的群聚或個案.
文章中提到幾項重點:
1. Lindane was used for many years to treat scabies, but it has fallen out of favor because of concerns regarding resistance to treatment
Lindane (必去蝨) : 已明顯出現產生抗藥性的蟲種
2. Study participants were randomly assigned to receive permethrin 5% cream to be applied twice during a 1-week interval, or oral ivermectin in a single dose of 200 µg/kg body weight.Researchers were blinded to the participants' treatment group.
選擇的治療方式為 Permethrin 5% QW x 2 times 與 ivermectin (Stromectol). 實驗是採用單盲進行.
3. Cure rates at 2 weeks were 92.5% in the permethrin group and 85.9% in the ivermectin group, a nonsignificant difference.
重點在這點: 外用治癒率 92.5% vs 口服 85.9%. 無統計差異
4. 17 participants whose condition failed to respond to ivermectin subsequently received permethrin, and all of these patients improved at 4 weeks.
In contrast, 7 of 9 participants who were crossed over to treatment with ivermectin continued to have severe itching.
permethrin 對於ivermectin失敗個案仍有其效果,但反之若permethrin治療無效,即使是給用ivermectin 也沒效
5. 6 participants in the permethrin group and 3 participants in the ivermectin group experienced irritation after application of the drug. No allergic reactions were recorded
並無過敏反應報告. 5% (permethrin) vs 2.5% (ivermectin) 的比率發生刺激感
結論: 
懶得看就看這裡吧
1. 台灣沒賣 permethrin 5%.
2. Ivermectin 商品名 Stromectol,
http://www.pharmaceutic.idv.tw/catalog/file/items/39.htm
3. 目前門診最大問題還是診斷, 沒經驗的醫師很容易出現偽陰性
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