We share Dr Rasmussen's concern that other scabicides may be less effective than gamma benzene hexachloride (lindane) and again acknowledge that further work is needed to ensure the safety of all of the available scabicides.However, we object to his minimization of our report by suggesting that only similarly malnourished infants would be prone to gamma benzene hexachloride toxic reactions. Although decreased subcutaneous fat tissue might cause preferential redistribution of the highly lipid-soluble gamma benzene hexachloride into a marasmic infant's brain, the unique infantile features of notably increased surface area for absorption (compared with body mass), plus the notably greater contribution of brain tissue to the total body lipid content, apply to normal as well as marasmic infants. Malnutrition and prematurity merely accentuate these attributes.Dr Rasmussen's anecdote of 23 million treated patients is similarly unconvincing, relative to the question of safety in infancy. How many infants younger
Hansen RC, Pramanik AK. Lindane Toxicity-Reply. Arch Dermatol. 1980;116(11):1226–1227. doi:10.1001/archderm.1980.01640350016003
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