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Lluch-Galcerá JJ, Carrascosa JM, Boada A. [Translated article] Epidemic Scabies: New Treatment Challenges in an Ancient Disease. Actas Dermosifiliogr 2023; 114:T132-T140. [PMID: 36462668 DOI: 10.1016/j.ad.2022.07.028] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 07/06/2022] [Indexed: 12/05/2022] Open
Abstract
Scabies which is among the most prevalent diseases worldwide, is becoming more frequent in Spain. The problems of this epidemic can be explained by several factors: improper application or prescription of treatments, resistance or reduced sensitivity to topical treatments, and poor understanding of the parasite and contagion. We require a new evidence-based approach to therapy that takes these problems into consideration. If symptoms persist after proper treatment, it is important to identify the reason for failure and standardize our approach. In refractory cases, the prescriber should prioritize oral medication, indicate a higher dose, combine treatments, or evaluate the use of off-label treatments in certain populations. The availability of new medications, such as spinosad or, especially, moxidectin, offer hope for bringing this disease under control.
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Affiliation(s)
- J J Lluch-Galcerá
- Servicio de Dermatología, Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Barcelona, Spain.
| | - J M Carrascosa
- Servicio de Dermatología, Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Barcelona, Spain
| | - A Boada
- Servicio de Dermatología, Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Barcelona, Spain
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Lluch-Galcerá JJ, Carrascosa JM, Boada A. Epidemic Scabies: New Treatment Challenges in an Ancient Disease. Actas Dermosifiliogr 2023; 114:132-140. [PMID: 35963332 DOI: 10.1016/j.ad.2022.07.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 07/06/2022] [Indexed: 02/06/2023] Open
Abstract
Scabies, which is among the most prevalent diseases worldwide, is becoming more frequent in Spain. The problems of this epidemic can be explained by several factors: improper application or prescription of treatments, resistance or reduced sensitivity to topical treatments, and poor understanding of the parasite and contagion. We require a new evidence-based approach to therapy that takes these problems into consideration. If symptoms persist after proper treatment, it is important to identify the reason for failure and standardize our approach. In refractory cases, the prescriber should prioritize oral medication, indicate a higher dose, combine treatments, or evaluate the use of off-label treatments in certain populations. The availability of new medications -such as spinosad or, especially, moxidectin- offer hope for bringing this disease under control.
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Affiliation(s)
- J J Lluch-Galcerá
- Servicio de Dermatología, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Barcelona, España.
| | - J M Carrascosa
- Servicio de Dermatología, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Barcelona, España
| | - A Boada
- Servicio de Dermatología, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Barcelona, España
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Ortega-Peña M, González-Cuevas R. Familiar Dermatologic Drugs as Therapies for COVID-19. Actas Dermosifiliogr (Engl Ed) 2020; 112:118-126. [PMID: 33045209 PMCID: PMC7546972 DOI: 10.1016/j.ad.2020.09.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 09/22/2020] [Accepted: 09/26/2020] [Indexed: 12/16/2022] Open
Abstract
Frente a la necesidad de encontrar una alternativa terapéutica que logre disminuir el impacto negativo de la COVID-19 y mejore el pronóstico actual de los pacientes, investigadores de todo el mundo se esfuerzan por aportar información que nos acerque a esta meta. Dentro de los potenciales fármacos, existen algunos de uso frecuente en dermatología: los antipalúdicos (cloroquina e hidroxicloroquina), la ivermectina, los antiandrógenos y la melatonina. Tanto estos como otros tratamientos se encuentran en la mira de la comunidad científica, siendo algunos foco de polémica y controversia. En el presente trabajo realizamos una revisión breve de los fármacos previamente mencionados, presentando los más recientes hallazgos con relación a su uso en la COVID-19.
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Affiliation(s)
- M Ortega-Peña
- Escuela de Medicina, Universidad Mayor, Santiago, Chile
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Salleras M, Alegre M, Alonso-Usero V, Boixeda P, Domínguez-Silva J, Fernández-Herrera J, García-Navarro X, Jiménez N, Llamas M, Nadal C, Del Pozo-Losada J, Querol I, Salgüero I, Schaller M, Soto de Delás J. Spanish Consensus Document on the Treatment Algorithm for Rosacea. Actas Dermosifiliogr (Engl Ed) 2019; 110:533-545. [PMID: 30837074 DOI: 10.1016/j.ad.2019.01.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Revised: 12/28/2018] [Accepted: 01/01/2019] [Indexed: 01/11/2023] Open
Abstract
Recent scientific evidence and the incorporation of new drugs into the therapeutic arsenal against rosacea have made it necessary to review and update treatment criteria and strategies. To this end, a panel of 15 dermatologists, all experts in rosacea, was formed to share experiences and discuss treatment options, response criteria, and changes to treatment. Based on a critical review of the literature and a discussion of the routine practices of Spanish dermatologists, the panel proposed and debated different options, with consideration of the experience of professionals and the preferences of patients or equality criteria. Following validation of the proposals, the final recommendations were formulated and, together with the evidence from the main international guidelines and studies, used to produce this consensus document. The goal of this consensus document is to provide dermatologists with practical recommendations for the management of rosacea.
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Affiliation(s)
- M Salleras
- Servicio de Dermatología, Hospital Universitario Sagrado Corazón, Barcelona, España.
| | - M Alegre
- Servicio de Dermatología, Hospital Plató, Barcelona, España
| | - V Alonso-Usero
- Servicio de Dermatología, Hospital Nisa 9 de Octubre, Valencia, España
| | - P Boixeda
- Sección de Dermatología, Hospital Ramón y Cajal, Madrid, España
| | - J Domínguez-Silva
- Servicio de Dermatología, Hospital Universitario de Gran Canaria Doctor Negrín, Las Palmas de Gran Canaria, España
| | | | - X García-Navarro
- Servicio de Dermatología, Consorci Sanitari del Garraf, Barcelona, España
| | - N Jiménez
- Sección de Dermatología, Hospital Ramón y Cajal, Madrid, España
| | - M Llamas
- Sección de Dermatología, Hospital de La Princesa, Madrid, España
| | - C Nadal
- Servicio de Dermatología, Hospital Son Llatzer, Palma de Mallorca, España
| | - J Del Pozo-Losada
- Servicio de Dermatología, Hospital Universitario A Coruña, La Coruña, España
| | - I Querol
- Universidad de Zaragoza, Zaragoza, España
| | - I Salgüero
- Servicio de Dermatología, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, España
| | - M Schaller
- Departamento de Dermatología, Universidad de Klinikum, Tubinga, Alemania
| | - J Soto de Delás
- Servicio de Dermatología, Policlínica Gipuzkoa, San Sebastián, España
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Sanz-Navarro J, Feal C, Dauden E. Treatment of Human Scabies with Oral Ivermectin. Eczematous Eruptions as a New Non-Reported Adverse Event. Actas Dermosifiliogr 2017; 108:643-649. [PMID: 28385424 DOI: 10.1016/j.ad.2017.02.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Revised: 02/04/2017] [Accepted: 02/24/2017] [Indexed: 10/19/2022] Open
Abstract
BACKGROUND Oral ivermectin is an alternative therapy for human scabies infection due to its ease of administration and good safety profile. However, there is no definitive consensus on the optimal dosing regimen. OBJECTIVE To describe the treatment of human scabies with different dosages of oral ivermectin and the possible adverse events. METHODS 23 patients with human scabies were treated with oral ivermectin: 10 patients received a single oral dose of 200μg/kg and 13 a dose of 400μg/kg. A second, or even a third dose, was administered in cases of treatment failure. RESULTS A complete clinical response was achieved by all of the patients. The first ten patients required at least two (80%) or three (20%) doses of ivermectin for complete resolution of the infection. The remaining cases resolved with a single 400μg/kg oral dose. Within the first 72h after the administration of oral ivermectin, new cutaneous lesions were observed in eleven patients (47.8%). Cutaneous biopsies showed signs of subacute eczema. The eruption was treated with topical corticosteroids and emollient therapy. There was no other new drug administration or a history of irritants. There was no history of atopic diathesis except for one patient. CONCLUSIONS Oral ivermectin is an effective therapy for the treatment of human scabies. A single 400μg/kg oral dose demonstrated high efficacy and good tolerance. However, the appearance of eczematous cutaneous lesions induced by oral ivermectin has not previously been reported in the literature. Dermatologists should be aware of this possible adverse event.
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Affiliation(s)
- J Sanz-Navarro
- Department of Dermatology, Hospital Rey Juan Carlos, Spain.
| | - C Feal
- Department of Dermatology, Hospital Universitario La Princesa, Spain
| | - E Dauden
- Department of Dermatology, Hospital Universitario La Princesa, Spain
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Hernando Y, Colwell K, Wright BD. Doing well while fighting river blindness: the alignment of a corporate drug donation programme with responsibilities to shareholders. Trop Med Int Health 2016; 21:1304-1310. [PMID: 27458720 DOI: 10.1111/tmi.12759] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Using the example of Merck's donations of ivermectin, to show how tax incentives and non-profit collaborators can make corporate largesse consistent with obligations to maximise returns to shareholders. METHODS We obtained information from publicly available data and estimated Merck's tax deductions according to the US Internal Revenue Code. Reviews of Merck-Kitasato contracts and personal interviews provided additional information regarding key lessons from this collaboration. RESULTS Our best estimate of the direct cost to Merck of the ivermectin tablets donated during 2005-2011 is around US$ 600 million, well below the stated value of US$ 3.8 billion. Our calculation of tax write-offs reduces the net cost to around US$ 180 million in that period. Indirect market benefits and effects on goodwill further enhanced the compatibility of Merck's donation programme with the company's profit-maximising objective. The case offers lessons for effective management of collaborations with public and non-profit organisations. CONCLUSION Merck's role in the donation of ivermectin for the treatment of onchocerciasis is widely and justly acknowledged as a prime example of corporate largesse in the public interest. It is nevertheless important to note that several public and non-profit collaborators, and United States taxpayers, played significant roles in increasing Merck's incentives, and indeed ability, to conduct the donation programme that changed so many lives in poor countries, while meeting its responsibilities to shareholders. Overall, the record indicates responsible corporate management of Merck's ivermectin programme and demonstrates the feasibility of socially responsible policies in a manner compatible with obligations to shareholders.
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Affiliation(s)
- Yolanda Hernando
- Centro de Edafología y Biología Aplicada del Segura (CEBAS), Consejo Superior de Investigaciones Científicas (CSIC), Espinardo, Murcia, Spain.
| | - Kaela Colwell
- Department of Agriculture and Resource Economics, University of California, Berkeley, CA, USA
| | - Brian D Wright
- Department of Agriculture and Resource Economics, University of California, Berkeley, CA, USA
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