Pediculosis and Phthiriasis

Pediculus humanus capitis ( head lice) Pediculus humanus corporis (body lice) Phthirus pubis (pubic lice)

Pediculosis
Head

lice are most commonly found in school children, with the most vulnerable age being 4-11 years old No significant sex differences Do not discriminate rich or poor Do not have any preference towards dirty or clean

Prevalence
Pediculosis

has a worldwide distribution In epidemiologic school surveys in different countries found to be :

15% in France (Combescot, 1990), 33.7% in Australia (Speare and Buettner, 1999), 40% in Taiwan (Fan et al., 1991) 28.3% in the U.K. (Downs et al., 2000) USA : has risen steadily over the last 3 decades (Guenther, L, Medscape)

Morphology and life cycle

Fam : Pediculidae, ordo : Anoplura Class : Insecta Consist of head, thorax and abdomen 3 pair of legs, with claw (to cling to and crawl through human hair) , wingless

permanent ectoparasite blood-sucking insects Die after 10 days starvation Incomplete metamorphosis

 Eggs

: laid at the base of hairs, about inch from the scalp A female louse can lay as many as 5 - 6 eggs each day (50-100 eggs in its lifetime) The eggs attach to the human hair with a material like super glue Eggs hatch after 7-10 days.

Morphology and habitat

P.humanus capitis P.humanus corporis Phthirus pubis
Pubic hair, eye lash, moustache and beard and armpit

Live on human clothing and hair bedding

Difficult to differentiate: Rounded body (crab muscle of the thorax of P. louse) humanus corporis clearly seen

Phthirus pubis ( crab louse)

Pathogenesis & symptoms

P.humanus capitis
Asimptomatic, itching, papules. Scratching : secondary infection - plica palonica

P.humanus corporis
Itching/ pruritus (play role as vector of epidemic typhus, trench fever, louse borne relapsing fever)

Phthirus pubis
Itching/ pruritus at pubic area eggs on eye lash can disturb eye vision

Source: Logical Image (Skin sight)

Phthiriasis
Pediculosis corporis

Diagnosis
Evidence
Favourite

of eggs/nits, nymph or adults

places : behind the ears / at the

nape of neck
Detection

combing

Source: DermAtlas (www.stanford.edu)

Treatment
Head lice :
Combing

and manual

Treatment
Insecticide

: Shampoo/ lotion / mousse of permetrin 1%, benzen hexachloride, pyrethrioid based Can be repeated after 10-14 days Cutting hair if needed

Treatment (contd)
Pediculosis

humanus corporis: change and wash clothing frequently Body lice : bedding should be fumigated
Pubic

lice : as recommended for head lice

Epidemiology
Transferred

from person to person through comb, mats, bedding Phthirus pubis : sexual activity P.humanus corporis : mostly in cool climate; poor personal hygiene