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pediculosis; phthiriasis (lice infestation, vagabond disease)

Etiology: - Pediculus capitis (head lice) - Pediculus humanus (body lice, vagabond disease) - Phthirus pubis (pubic lice) Epidemiology: 1) all 3 species of human lice feed at least once a day on human blood 2) females firmly cement their eggs to hair or clothing Pathology: - saliva of lice produces an intensely pruritic maculopapular or urticarial rash Clinical manifestations: - pruritus - maculopapular or urticarial rash - postinflammatory hyperpigmentation & thickening of skin * image phthiriasis palpebrarum [4] Laboratory: - finding of lice on hairs or clothing Management: 1) topical permethrin 1% or malathion 0.5% kills both lice & eggs 2) 1% lindane is NOT ovicidal & requires a 2nd application after 1 week to kill hatching nymphs

Related

pediculidae

General

infestation; ectoparasitic infection

References

  1. Harrison's Principles of Internal Medicine, 13th ed. Isselbacher et al (eds), McGraw-Hill Inc. NY, 1994, pg 935-36
  2. Medical Knowledge Self Assessment Program (MKSAP) 16 American College of Physicians, Philadelphia 2012
  3. Wolf R, Davidovici B. Treatment of scabies and pediculosis: facts and controversies. Clin Dermatol. 2010 Sep-Oct;28(5):511-8. PMID: 20797511
  4. Feng X, Qi H Images in Clinical Medicine: Phthiriasis Palpebrarum N Engl J Med 2021; 385:e5. July 8 PMID: 34233108 https://www.nejm.org/doi/full/10.1056/NEJMicm1913478