PEDICULOSIS

Pediculosis is an infestation of the hairy parts of the body or clothing with the eggs, larvae or adults of
lice. The crawling stages of this insect feed on human blood, which can result in severe itching. Head lice
are usually located on the scalp, crab lice in the pubic area and body lice along seams of clothing. Body
lice travel to the skin to feed and return back to the clothing.

3 KINDS OF PEDICULOSIS

1. PEDICULUS HUMANUS CAPITIS

(HUMAN LOUSE)
-PEDICULOSIS CAPITIS

2. PEDICULUS HUMANUS CORPORIS

(BODY LOUSE)
-PEDICULOSIS CORPORIS

3. PTHIRUS PUBIS
(CRAB LOUSE)
-PEDICULOSIS PUBIS
-PEDICULOSIS CILARIS
 LICE: TRANSMISSION AND LIFE CYCLE
The head louse begins as an egg laid near the scalp and “glued”
firmly to a hair shaft. After three to four days, the embryo’s
central nervous system is fully developed.
It hatches as a nymph in 7 to 10 days. 9-12 days after hatching,
the nymph develops into a sexually mature male or female.
Within 24 hours of mating, the mature female louse begins
laying 7-10 eggs a day. Repeated fertilization is not required.
Adult lice can live up to 30 days on a person’s head. To live,
adult lice need to feed on blood several times daily.
Without blood, the louse will die within 1 to 2 days off the host.

HEAD LICE
• Direct contact
• Indirect contact (fomites)
• Adult lice are 2-3mm in size
• Female louse lives 1 month, laying 7-10 nits/day

BODY LICE
• Direct contact
• Indirect contact (clothing)
• Adult lice are 2-4mm in size
• Lives in clothing and lays eggs in seams of clothing
• Can live up to 3 days without feeding on host

PUBIC LICE
• Sexually transmitted
• Fomites
• Adult crab louse is 0.8 to 12mm in size
• Female crab louse lives for 3-4 weeks, laying 3 nits/day

ETIOLOGY

Pediculosis is spread by direct with an infested person. Head-to-had contact with an infested individual
at school, at home and while playing may result in head lice infestation. Personal hygiene and
environmental cleanliness are not risk factors. Fomites, such as clothing, headgear, hats, combs,
hairbrushes, hair barrettes, may occasionally play a role in the spread of head lice.
EPIDEMIOLOGY

HEAD LICE

• Children most commonly affected

• Females are more often affected than males

• Individuals of European descent higher likelihood of infestation than those of African descent

BODY LICE

• Poverty

• Poor hygiene

• Crowding

PUBIC LICE

• Sexually active

• Young adults, adolescents

SIGNS AND SYMPTOMS

• Intensely pruritic due to allergic reaction from lice saliva

• Small red bumps on the scalp, neck and shoulders.

• The presence of lice on the scalp

• The presence of nits on the shafts of hair

• Difficulty sleeping, which can lead to irritability

ASSOCIATED CONDITIONS

• Secondary bacterial infections from excoriations

ex: impetigo

• Lice can transmit bacterial infections

• Bartonella Quintana (causative agent of trench fever)

• Rickettsia prowazekii (causative agent of typhus)

PATHOPHYSIOLOGY
DIAGNOSIS

• Should be suspected in patients with scalp pruritis, particularly in children.

• Persistent pyoderma around the neck or ears should also stimulate an evaluation for pediculosis
capitis.

• A bright light, a magnifying lens and separating the hair aids inspection. Systematically combing
wet or dry with a fine-toothed nit comb (teeth of comb 0.2 mm apart) better detects active
louse infestation than visual inspection of the hair and scalp alone.

• The presence of nits only does not necessarily indicate active infestation.

• Active infestation is suggested by the finding of many nits within one-quarter inch (6.5mm) of
the scalp, nits further from the scalp are almost nonviable.

• Wetting hair with water, oil or a conditioner and using a fine-tooth comb may improve the
ability to diagnose.

TREATMENT

• Treatment is recommended for people who have an active infestation of head lice. All
household members and other close contacts should be checked and treated if necessary. It is
important to treat everyone at the same time.

• Topical pediculicides are the most common initial treatments.

• Manual removal of lice (wet combing) is sometimes used as alternative to topical pediculicides
therapy.

• Oral therapy is occasionally required refractory infestations.

• Pharmacologic treatment of head lice infestation is focused on two general mechanisms:

neurotoxicity that results in paralysis of the louse and suffocation via “coating” the louse.

• Most clinical trials use substances that work via neurotoxicity.

MEDICATIONS FOR LICE TREATMENT

DIMETHICONE

• Is a nonpesticide, silicone-based material believed

to work by coating lice and disrupting their ability
to manage water, flows into breathing system to
suffocate lice, nymphs and nits.
• Efficacy of dimethicone is documented on multiple
studies.
• It kills lice by suffocation and disrupting their
ability to regulate water.
PYRETHROIDS (PYRETHRINS AND PERMETHRIN)

 Well tolerated and inexpensive treatments that

have a long history of use for pediculosis
capitis.
 Pyrethroids are the preferred choice for initial
therapy in areas where resistance to these products
has not been proven.
 Pyrethrins can be used for patients above 2 years of
age.
 Permethrin can be used for patients above 2 months
of age.

MALATHION

 It is highly effective in the treatment of resistant head

lice infestation.
 Because of its odor, flammability, and potential for
causing respiratory depression if ingested, malathion
is considered a second-line agent.
 Contraindicated in children under the age of two.
 Its safety in nursing mothers and children under six
years of age is uncertain.

PREVENTIONS

• Avoid direct head-to-head contact with anyone known to have live, crawling lice

• Do not share combs, brushes, hats, scarves, bandannas, ribbons, barrettes, hair bands, towels,
helmets, or other hair related personal items with anyone else, whether they have lice or not.

• Avoid sleepovers and slumber parties during lice outbreaks. Lice can live in bedding, pillows, and
carpets that have recently been used by someone with lice.

• After finishing treatment with lice medicine, check everyone in your family for lice after one
week.

• Machine or wash any bedding and clothing used by anyone having lice.

• Machine wash at high temperatures (150°F) and tumble in a hot dryer for 20 minutes.
 ASSESSMENT DIAGNOSIS PLANNING INTERVENTION RATIONALE EVALUATION
SUBJECTIVES: Risk for After 4 hours of  Assess the  Assessing After 4 hours of
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 ASSESSMENT DIAGNOSIS PLANNING INTERVENTION RATIONALE EVALUATION
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 ASSESSMENT DIAGNOSIS PLANNING INTERVENTION RATIONALE EVALUATION
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