2.4.4 Pediculosis Capitis
Grading & Level of Importance: A
Head lice infestation; head lice; nits.
Pruritic scalp lesions usually in children caused by bites of the head lice, followed by strong itching.
Aetiology & Pathogenesis
Head lice (Pediculus capitis, 2.25-4 mm) are strictly human-specific ectoparasites. The larvae hatch from eggs after 7 days and after a total of 2-3 weeks, the adult lice are sexually mature. Transmission is from human-to-human, especially under cramped living conditions.
Signs & Symptoms
Sometimes markedly pruritic erythematous papules, especially found on the retroauricular and occipital areas and the nape of the neck. Nits (eggs) are firmly attached to hair shafts, whereas adult lice move freely.
Usually scalp, especially retroauricular and occipital.
Laboratory & other workups
Dermatoscopic examination of the hair shaft may show the lice and the nits attached to the hair.
Recurrences are common if improperly treated or re-contamination.
Impetiginisation with associated occipital and/or cervical lymphadenopathy; hairs can become matted with pus and crust.
Clinical features. Identification of nits or lice.
Prevention & Therapy
Prevention measures: Combs, brushes and hats should not be shared.
Prevention of reinfection: Contact persons should be examined and treated as required in parallel. It is important to wash clothing, bedding and towels at 60°C minimum and dry well. Place items which cannot be washed in airtight plastic bags for 14 days and clean combs and hair brushes in hot soapy water. Vacuum carpets, rugs, furniture and mattresses.
Therapy: Wet combing (nit comb, fine-toothed comb), first line dimethicone, 5% topical permethrin, pirethrins, malathion, ivermectin.
- True or false?
- Statement 1 Pediculosis capitis is seen primarily in children
- Which of the following therapies are appropriate for pediculosis capitis?
- Which of the following are differential diagnostic considerations for pediculosis capitis?
- Which of following fall into the differential diagnostic considerations for pediculosis capitis?
- Which of these statements about pediculosis capitis is false?
- Appropriate treatment/s for pediculosis capitis:
- Which of these factors does not favor the transmission of pediculosis capitis?
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