Clinical study
Improvement in severe onchocercal skin disease after a single dose of ivermectin*

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Purpose:

Skin disease is the most common clinically important manifestation of onchocerciasis. Ivermectin, a newly available drug, is well tolerated and effective in Onchocerca volvulus infection. However, little information is available regarding its effect on onchocercal skin disease. The purpose of this study was to examine, in patients with well-characterized onchodermatitis, the effect of a single dose of ivermectin.

Subjects and Methods:

Twenty-one persons with severe onchodermatitis were followed over a 6-month period. In order to evaluate the effect of ivermectin on their skin lesions, photographic transparencies were made before treatment and at 3 and 6 months after treatment. These were then evaluated in a blinded fashion.

Results:

Following a single dose of 150 μg/kg, there was a significant improvement in dermatitis in the first 3 months after treatment. All 14 persons with the worst skin disease showed improvement. The drug had no demonstrable effect on depigmented lesions over the period of observation. Treatment was well tolerated.

Conclusion:

Single-dose ivermectin shows promise as the first acceptable treatment for severe onchocercal dermatitis.

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    *

    This work was supported in part by funds from the UNDP/World Bank/ WHO Special Programme for Research and Training in Tropical Diseases (#870096), by the Onchocerciasis Chemotherapy Project of the FAO/ UNDP/World Bank/WHO Onchocerciasis Control Programme in the Volta River Basin, and U.S. Public Health Service National Institutes of Health Grants RR 04060, AI 15351, EY 03318, and AR 32593. Dr. Elmets is the recipient of a National Institutes of Health Research Career Development Award (AR 01765).

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