The pediculosis are benign and contagious parasitic diseases due to three species of lice specific to humans: head lice, body lice and pubic lice. Person transmission is by direct and indirect contact.
Body lice are potential vectors of relapsing fever, typhus and trench fever.
Clinical signs:
– Head lice mainly affect children: itching and scratch marks (neck, around the ears), which may become secondarily infected (impetigo) in prolonged infestation; presence of live lice and / or live nits (shiny, pearly, located at <5 mm from the root of the hair).
– Body lice mainly affect people in precarious situations (refugees, prisoners, homeless): itching and scratch marks (back, waist, sleeves), often inflammatory and infected; lice and nits on clothing (not found parasite on the body).
– Pubic lice are considered a sexually transmitted infection (STI): itching and scratch marks (pubic area and perianal), but other hairy areas may be affected (armpits, thighs, eyelashes); lice or nits in the base of the bristles, rarely visible.
– Examine the patient contacts; in case of body lice, search a systemic infection, in case of pubic lice, an associated STI.
Treatment:
Head lice:
Apply to dry hair 1% permethrin lotion (10 min) or malathion 0.5% (12 hours 8 hours in children 6 months-2 years).Do not shorten or extend the time to contact.Rincer thoroughly. Decontaminate combs, hats / scarves, bed linen (washing ³ 60 ° C / 30 min, ironing or drying in the sun, or, if none of these methods is possible, insulation material in a sealed plastic bag for 2 weeks) . Treated in the same way the contacts with lice and / or live nits (not dead slow carriers ie d. Slow dull, white, situated> 1 cm from the root of the hair). It is best to reapply after 10 days.
Body lice:
For mass treatment (outbreak), apply 30-60 g (2-4 tablespoons well-filled soup.) Powder 0.5% permethrin: let the patient dressed, sprinkle permethrin on the inside and under clothing -Clothing in contact with the skin (front, behind, at the collar, sleeves, belt, socks) and divide by friction.
Incubate at 12 to 24 hours. Treat other clothing (including hats, scarves) and bed linen, in a plastic bag with 0.5% permethrin powder. Repeat 8 to 10 days if the infestation persists.
For individual treatment, deworming clothes and bed linen as above or as for head lice.
Pubic lice:
Shave and / or apply on hairy areas of permethrin 1% (as for head lice). Treat partner simultaneously.Decontaminate clothing and bed linen (as for head lice). Reapply 7 days later.
The treatment of a bacterial infection, if present, should begin 24 to 48 hours before the local pest control; local treatment is applied when the skin can tolerate it.
