Pediculosis (capitis, corporis, and pubis) share well-known
features: worldwide prevalence (involving millions of
people annually); parasites inducing skin lesions directly,
and indirectly as a result of itching and hypersensitivity to
parasites; and treatment based on good entomological
knowledge of the parasite and practical considerations
(ie, most available treatments do not act on eggs and
should be repeated, depending on the life cycle of the
parasites). Infestations are spread most commonly by
close contacts. Social stigma and persistent misconceptions
complicate the implementation of appropriate
management strategies. Head and pubic lice infestations
are diagnosed by the visualization of insects or viable
nits (eggs). Primary treatments are topical pediculicides
(permethrin or malathion), used twice, but emergence
of resistance against pediculicides has created the
need of alternative treatments including topical or oral
ivermectin. Pubic lice are treated the same as head lice,
but this finding should prompt evaluation for other sexually
transmitted diseases. Body lice infestation should be
suspected when symptoms of generalized itching occur
in persons who do not change or wash their clothing or
bedding regularly; lice may be found in the seams of their
clothing. Topically administered permethrin may help to
eradicate body lice, but personal hygiene measures are
essential for successful treatment. Environmental treatment
is also necessary for the eradication of the infestation.
Health care personnel who come into contact with this
population need to be well informed of the facts in order
to disseminate accurate information for diagnosis and
management.
Semin Cutan Med Surg 33:116-118 © 2014 Frontline Medical
CommunicationsPediculosis (capitis, corporis, and pubis) share well-known
features: worldwide prevalence (involving millions of
people annually); parasites inducing skin lesions directly,
and indirectly as a result of itching and hypersensitivity to
parasites; and treatment based on good entomological
knowledge of the parasite and practical considerations
(ie, most available treatments do not act on eggs and
should be repeated, depending on the life cycle of the
parasites). Infestations are spread most commonly by
close contacts. Social stigma and persistent misconceptions
complicate the implementation of appropriate
management strategies. Head and pubic lice infestations
are diagnosed by the visualization of insects or viable
nits (eggs). Primary treatments are topical pediculicides
(permethrin or malathion), used twice, but emergence
of resistance against pediculicides has created the
need of alternative treatments including topical or oral
ivermectin. Pubic lice are treated the same as head lice,
but this finding should prompt evaluation for other sexually
transmitted diseases. Body lice infestation should be
suspected when symptoms of generalized itching occur
in persons who do not change or wash their clothing or
bedding regularly; lice may be found in the seams of their
clothing. Topically administered permethrin may help to
eradicate body lice, but personal hygiene measures are
essential for successful treatment. Environmental treatment
is also necessary for the eradication of the infestation.
Health care personnel who come into contact with this
population need to be well informed of the facts in order
to disseminate accurate information for diagnosis and
management.
Semin Cutan Med Surg 33:116-118 © 2014 Frontline Medical
Communications
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