COMPARATION OF THE EFFICACY OF ORAL IVERMECTIN COMBINED TOPICAL METRONIDAZOL 1% WITH ORAL AND TOPICAL METRONIDAZOL IN THE TREATMENT OF DEMODICOSIS

Abstract

Objectives: To compare the treatment outcomes of pityriasis folliculitis by combining oral ivermectin with topical metronidazol 1% and combining oral with topical metronidazol therapy.
 Method: 70 patients with pityriasis folliculitis were randomly divided into 2 groups: 35 patients in group one were treated with oral ivermectin (one dose of 200 µg/kg) and topical metronidazol 1%. 35 patients in group two were treated with oral metronidazol (doses 500 mg per day for 2 weeks) and topical metronidazol 1%. Demodex was detected by standardized skin surface biopsy. The subjects were followed-up at week 2 and 4 after the treatment.
 Result: After 2 and 4 weeks of the treatment, pruritus, red papules, red patchs and skin scabs in both groups reduced. There was no differences between the two groups regarding age, sex and duration of the condition (p> 0.05). Group one had greater reductions in Demodex density than those in the group two (p < 0.05). Moreover, at week 4, the group one treated with oral ivermectin and topical metronidazol, 80% had good improvement, 14.3%:moderate improvement and 5.7%: mild improvement. Meanwhile, in the group treated by combining oral and topical metronidazol, the rates were 71.4%, 22.9% and 5.7%, respectively. The outcomes of the treatment in both groups had no significant difference (p > 0.05). Side effects including pruritus, burning in group one were lower than that of group two (p < 0.05).
 Conclusion: There were no differences in clinical improvement in the two groups treated by two different therapies. However, the reductions of the number of Demodex in the group one were higher than those in the group two. On the other hand, the side effects in the group one were less than those in the group two