PEDICULOSIS

• Pediculosis


  Any human infestation of lice
• Pediculosis


  • May occur anywhere on the body
• Types of pediculosis


  • Pediculosis capitis
  • Pediculosis corporis
  • Pediculosis pubis
• Pediculosis capitis


  Lice feed on the scalp and rarely, on the skin under the eyebrows, eyelashes and beard
• Pediculosis corporis


  Lice live next to the skin in clothing seams
• Pediculosis pubis


  Lice are found primarily in pubic hairs but may extend to the eyebrows, eyelashes and axillary or body hair
• Modes of transmission


  • Head-to-head contact
  • Fomites
  • Sexual activity
• Incubation period


  3 to 7 days
• Clinical manifestations


  • Pruritis (most common symptom of infestation)
  • Tickling sensation of something moving in the hair may be noticed
  • Head lice and their nits are most commonly found behind the ears and on the hairs of the neck and occiput
  • Body lice are found on clothing seams
  • Pubic lice will be found attached to the base of the pubic hair and the infestation generally results in severe itching
• Diagnostic tests


  • Wood's light examination (fluorescence of the adult lice)
  • Microscopic examination (presence of nits on the hair shaft)
• Treatment modalities


  • Permethrin (Eliminate) / Pyrethin (Rid Mousse) (initial treatment of choice, topical insecticide)
  • Fine-tooth comb dipped in vinegar
  • Washing hair with ordinary shampoo
  • Oral Anthelminthics (Ivermectin, Levamisole, Albendazole) are effective against head lice infestation
• Prevention of head reinfestation

  1. Clothes and bed linens must be washed in hot water, ironed or dry cleaned

  2. Storing clothes or linens for more than 30 days or placing them in dry heat of 140 F (60 C) kills lice
• Complications


  • Excoriation
  • Secondary bacterial infections
  • If left untreated, pediculosis may result in dry, hyperpigmented, thickly encrusted, scaly skin, with residual scarring
• Nursing considerations


  • Contact precautions should be maintained until treatment is complete to prevent spreading the infection
  • Have the patient's fingernails cut short to prevent skin breaks and secondary bacterial infections caused by scratching
  • Be alert for possible adverse reactions to treatment with an antiparasitic, including sensitivity reactions and in some cases, central nervous system (CNS) toxicity
  • To prevent self-infestation, avoid direct contact with the patient's hair, clothing and bedsheets
  • Use gloves, a gown, and a protective head covering when administering delousing treatment
  • After each treatment, inspect the patient for remaining lice and eggs
  • Teach the patient and family how to inspect and identify lice, eggs and related lesions
  • Instruct the patient and family about the use of the creams, lotions, powders and shampoos that eliminate lice
  • Instruct the patient in the proper application of lindane, which can be absorbed by the skin and cause CNS complications