Turkiye Klinikleri Journal of Dermatology

.: ORIGINAL RESEARCH
The Efficacy, Safety and Tolerability of Sulfur in the Treatment of Scabies: A Cross-Sectional Study
Skabiyez Tedavisinde Sülfürün Etkinliği, Güvenirliği ve Tolerabilitesi: Kesitsel Araştırma
Cemile Tuğba ALTUNELa
aDepartment of Dermatology, Başkent University Faculty of Medicine, Ankara, Türkiye
Turkiye Klinikleri J Dermatol. 2022;32(3):175-83
doi: 10.5336/dermato.2022-92465
Article Language: EN
Full Text
ABSTRACT
 Objective: The incidence of scabies has been increasing. The emergence of cases non-responsive to permethrin has urged the need for alternative treatments. Although sulfur has been considered an option for scabies treatment, there has been no conclusive data on this topic. The study was conducted to determine the efficacy and safety of sulfur in scabies. Material and Methods: All scabies patients treated with topical sulfur from January 2020 to February 2022 were included in the study. Procedurally, 5-10% sulfur was applied on three consecutive days and washed off every 24 hours (the duration varied depending on the patient-related factors or clinician's experience). The treatment was repeated if there was no cure at control. Results: There were 64 (39 female) patients. After 3-day treatment, 72% were cured. The overall cure rate was 92%. The median duration of therapy was three days (2-30). The length of treatment was correlated with the duration of pruritus before diagnosis and was longer in patients with widespread lesions. The side effects were more severe in those with extended lesions and those with more prolonged treatment. Conclusion: The present study demonstrates that sulfur is effective in majority of the patients after 3-day treatment. Most patients had no or minimal side effects. As the side effects increase with the length of treatment, the additional application should be reserved for those who are not cured at the control visit. Particular attention should be given to patients with widespread lesions since they require prolonged treatment and have an increased risk of side effects.

Keywords: Scabies; sulfur; therapy; drug resistance; permethrin
ÖZET
 Amaç: Skabiyez (uyuz) insidansı giderek artmaktadır. Permetrine yanıt vermeyen vakaların ortaya çıkması alternatif tedavilere ihtiyaç duyulmasına neden olmuştur. Sülfür (kükürt), skabiyez tedavisinde bir seçenek olarak görülse de bu konuda net bir veri bulunmamaktadır. Bu çalışmada, skabiyez tedavisinde sülfürün etkinliğinin ve güvenirliğinin belirlenmesi amaçlanmıştır. Gereç ve Yöntemler: Bu çalışmaya Ocak 2020-Şubat 2022 tarihleri arasında topikal sülfür ile tedavi edilen tüm skabiyez hastaları dâhil edildi. Standart prosedür olarak %5-10'luk sülfür art arda 3 gün verildi ve her 24 saatte 1 yıkandı (tedavi süresi, hasta-ilişkili faktörlere veya klinisyenin deneyimine bağlı olarak değişmekteydi). Kontrolde iyileşmeyen hastalara tedavi tekrarlandı. Bulgular: Çalışmada 64 (39 kadın) hasta vardı. Üç günlük tedaviden sonra %72 hasta kür olmuştu. Toplamda kür oranı %92 idi. Ortanca tedavi süresi 3 gündü (2-30). Tedavi süresi tanı öncesi kaşıntı süresi ile koreleydi ve yaygın lezyonu olan hastalarda daha uzundu. Yaygın lezyonları olan ve daha uzun süre tedavi alan hastalarda yan etkiler daha şiddetliydi. Sonuç: Bu çalışma, topikal sülfürün 3 günlük tedaviden sonra hastaların önemli bir kısmında etkili olduğunu göstermektedir. Çoğu hastada yan etki yoktu veya hafifti. Tedavi süresi uzadıkça yan etkiler arttığından ek uygulama kontrolde iyileşmeyen hastalara yapılmalıdır. Yaygın lezyonları olan hastalara uzun süre tedavi gerektiği ve artmış yan etki riski taşıdıkları için özel dikkat gösterilmelidir.

Anahtar Kelimeler: Skabiyez; sülfür; tedavi; ilaç direnci; permetrin
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