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CHICAGO - Parents who paid $285 for an experimental head lice treatment for their children might be scratching their own heads, now that the doctor selling the stuff says it's really a skin cleanser available for under $10 a bottle nationwide.

Dr. Dale Pearlman got widespread media attention and skepticism from some head lice experts when his study was published last year in Pediatrics, detailing results with a product he called Nuvo lotion. He described it as a "dry-on suffocation-based pediculocide" and the first in a new class of nontoxic lotions for head lice.

And as of last week, his Web site still said the costly treatment was only available at his Menlo Park, Calif. office.

But now, in a letter to the editor for release Monday in December's Pediatrics, Pearlman says the treatment "was actually Cetaphil cleanser," available over-the-counter nationwide and made by a Texas-based company he has nothing to do with.

The letter "kinds of blows the cover," said University of Minnesota medical ethicist Dr. Jeffrey Kahn, who called Pearlman's failure until now to disclose his product's true identity ethically troubling.

"He seems to imply that you could do it yourself" - something patients would have wanted to know, as well as doctors and Pediatrics' peer reviewers who read last year's study, Kahn said.

"You don't pull tricks on your colleagues and the peer review," Kahn said.

Leonard Fleck, a Michigan State University medical ethicist, said Pearlman's lack of disclosure in the original study made it impossible for other scientists to test his methods.

"At the very least there's deception there for reasons of self-interest," Fleck said.

Pearlman acknowledged that he didn't disclose until now "because I wanted to get rich" and had hoped pharmaceutical companies would have offered him money to further develop a Cetaphil-based product for head lice. When that didn't happen, he says he decided to fess up.

"I thought it would be so fun to make the world a better place by telling everyone about this," Pearlman said in a phone interview.

He declined to say how many patients had sought the treatment since his study was published. He said they were given bottles to take home and were told the treatment was part of his research, but not that they were getting Cetaphil. He would not disclose how much money he'd made from those visits.

Pearlman said his treatment should still be considered novel because it uses Cetaphil in a new way, having patients apply the lotion to the scalp and drying it with a hair dryer to suffocate head lice. He has "method of use" U.S. patents for the process.

It usually takes about three bottles to work, plus diagnostic testing that makes the in-office price worth it, Pearlman said.

Brent Petersen, communications manager for Galderma Laboratories LP, Cetaphil's maker, called Pearlman's tactics "a bit misleading" but said the company knew nothing about Pearlman's use of Cetaphil until learning of his letter.

"We'll obviously look into it," Petersen said.

He said Cetaphil's label clearly states that it is a skin cleanser and that Galderma has no data confirming or denying that it is an effective head lice treatment.

A spokeswoman for the California Medical Board said they have no public record of any disciplinary action against Pearlman, but that complaints and investigations are not public information.

Dr. Jerold Lucey, Pediatrics' editor, called Pearlman "a bit of a huckster" and said, in hindsight, when Pearlman submitted his study, "I probably would have said, 'We can't publish this if you can't tell us what it is."

But, said Lucey, "You've got to give him points for writing" to set the record straight.

AP-CS-12-04-05 1333EST


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