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American Family Physician May 2019Pediculosis and scabies are caused by ectoparasites. Pruritus is the most common presenting symptom. Head and pubic lice infestations are diagnosed with visualization of... (Review)
Review
Pediculosis and scabies are caused by ectoparasites. Pruritus is the most common presenting symptom. Head and pubic lice infestations are diagnosed with visualization of live lice. Nits (lice eggs or egg casings) alone are not sufficient to diagnose a current infestation. A "no-nit" policy for return to school is not recommended because nits can remain even after successful treatment. First-line pharmacologic treatment for pediculosis is permethrin 1% lotion or shampoo. Newer treatments are available but costly, and resistance patterns are generally unknown. Noninsecticidal agents, including dimethicone and isopropyl myristate, show promise in the treatment of pediculosis. Extensive environmental decontamination is not necessary after pediculosis is diagnosed. In adults, the presence of pubic lice should prompt an evaluation for sexually transmitted infections. Body lice infestation should be suspected in patients with pruritus who live in crowded conditions or have poor hygiene. Scabies in adults presents as a pruritic, papular rash in a typical distribution pattern. In infants, the rash can also be vesicular, pustular, or nodular. First-line treatment for scabies is permethrin 5% cream. Clothing and bedding of persons with scabies should be washed in hot water and dried in a hot dryer. Counseling regarding appropriate diagnosis and correct use of effective therapies is key to reducing the burden of lice and scabies.
Topics: Adult; Animals; Antifungal Agents; Humans; Insecticides; Lice Infestations; Permethrin; Scabies
PubMed: 31083883
DOI: No ID Found -
American Family Physician May 2019
Topics: Animals; Humans; Lice Infestations; Macrolides; Patient Education as Topic; Phthiraptera; Scabies
PubMed: 31083888
DOI: No ID Found -
Deutsches Arzteblatt International Nov 2016Conflicting information about the proper treatment of head lice has given rise to uncertainty among patients and treating personnel. For example, the reported efficacy... (Review)
Review
BACKGROUND
Conflicting information about the proper treatment of head lice has given rise to uncertainty among patients and treating personnel. For example, the reported efficacy of permethrin fell from 97% in the 1990s to 30% in 2010.
METHODS
Review of the literature based on a selective search of PubMed.
RESULTS
In Germany, outbreaks of head lice mainly occur among 5- to 13-year-olds returning to school after the summer vacation. Nymphs hatch from eggs after an average of 8 days and become sexually mature lice over the ensuing 9 days. The main route of transmission is direct head-to-head contact; transmission via inanimate objects is of no relevance. Symptoms arise 4-6 weeks after an initial infestation; many affected persons have no symptoms at all. Wet combing is the most sensitive method of establishing the diagnosis and monitoring treatment. Resistance to neurotoxic pediculocidal drugs is increasing around the world. Dimethicones are the treatment of choice, with 97% efficacy. Outbreaks must be managed with the synchronous treatment of all infested persons to break the chain of infestation. If the agent used is not ovicidal, the treatment must be repeated in 8-10 days and sometimes in a further 7 days as well.
CONCLUSION
Outbreaks of head lice can be successfully terminated by synchronous treatment with ovicidal dimethicones.
Topics: Animals; Disease Outbreaks; Germany; Humans; Insecticides; Lice Infestations; Pediculus; Permethrin
PubMed: 27974145
DOI: 10.3238/arztebl.2016.0763 -
BMJ Clinical Evidence Jan 2015Head louse infection is diagnosed by finding live lice, as eggs take 7 days to hatch (but a few may take longer, up to 13 days) and may appear viable for weeks after... (Review)
Review
INTRODUCTION
Head louse infection is diagnosed by finding live lice, as eggs take 7 days to hatch (but a few may take longer, up to 13 days) and may appear viable for weeks after death of the egg. Infestation may be more likely in school children, with risks increased in children with more siblings or of lower socioeconomic group. Factors such as longer hair make diagnosis and treatment more difficult.
METHODS AND OUTCOMES
We conducted a systematic review and aimed to answer the following clinical question: What are the effects of physically acting treatments for head lice? We searched: Medline, Embase, The Cochrane Library, and other important databases up to March 2014 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA).
RESULTS
We found six studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions.
CONCLUSIONS
In this systematic review, we present information relating to the effectiveness and safety of the following interventions: 1,2-octanediol, dimeticone, herbal and essential oils, and isopropyl myristate.
Topics: Animals; Antiparasitic Agents; Dimethylpolysiloxanes; Humans; Lice Infestations; Myristates; Octanols; Oils, Volatile; Pediculus; Treatment Outcome
PubMed: 25587918
DOI: No ID Found -
American Family Physician Jan 2004Pediculosis and scabies are caused by ectoparasites; patients usually present with itching. Head and pubic lice infestations are diagnosed by the visualization of... (Review)
Review
Pediculosis and scabies are caused by ectoparasites; patients usually present with itching. Head and pubic lice infestations are diagnosed by the visualization of insects or viable nits (eggs). Primary treatment is topically administered 1 percent permethrin. Malathion is one alternative for treatment failures. The importance of environmental measures to prevent infestation is a matter of controversy. Pubic lice are treated the same as head lice, but this finding should prompt evaluation for other sexually transmitted diseases. Body lice infestation should be suspected when symptoms of generalized itching occur in persons who do not change or wash their clothing or bedding regularly; lice may be found in the seams of their clothing. Topically administered permethrin may help to eradicate body lice, but personal hygiene measures are essential for successful treatment. Classic scabies in adults can be recognized by a pruritic, papular rash with excoriations; in infants, small children, and the immunocompromised, the rash may include vesicles, pustules, or nodules. Primary treatment for scabies is permethrin cream and environmental measures are important to prevent recurrent infestation. Generalized crusted scabies is best treated with oral ivermectin.
Topics: Humans; Lice Infestations; Scabies
PubMed: 14765774
DOI: No ID Found -
CMAJ : Canadian Medical Association... Mar 2023
Topics: Humans; Lice Infestations; Eyelashes; Eyelid Diseases
PubMed: 36972915
DOI: 10.1503/cmaj.221649 -
BMJ Clinical Evidence May 2011Head lice can only be diagnosed by finding live lice, as eggs take 7 days to hatch and may appear viable for weeks after death of the egg. Infestation may be more likely... (Review)
Review
INTRODUCTION
Head lice can only be diagnosed by finding live lice, as eggs take 7 days to hatch and may appear viable for weeks after death of the egg. Infestation may be more likely in school children, with risks increased in children with more siblings, longer hair, and of lower socioeconomic group.
METHODS AND OUTCOMES
We conducted a systematic review and aimed to answer the following clinical question: What are the effects of treatments for head lice? We searched: Medline, Embase, The Cochrane Library, and other important databases up to June 2010 (Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA).
RESULTS
We found 26 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions.
CONCLUSIONS
In this systematic review, we present information relating to the effectiveness and safety of the following interventions: benzyl alcohol, dimeticone, herbal and essential oils, insecticide combinations, isopropyl myristate, ivermectin, lindane, malathion, mechanical removal by combing ("bug busting"), oral trimethoprim-sulfamethoxazole (co-trimoxazole, TMP-SMX), permethrin, phenothrin, pyrethrum, and spinosad.
Topics: Animals; Humans; Lice Infestations; Pediculus; Permethrin; Scalp Dermatoses; Trimethoprim, Sulfamethoxazole Drug Combination
PubMed: 21575285
DOI: No ID Found -
The American Journal of Tropical... Aug 2022
Topics: Humans; Lice Infestations
PubMed: 35895349
DOI: 10.4269/ajtmh.22-0265 -
BMJ Clinical Evidence Jan 2009Head lice can only be diagnosed by finding live lice, as eggs take 7 days to hatch and may appear viable for weeks after death of the egg. Infestation may be more likely... (Review)
Review
INTRODUCTION
Head lice can only be diagnosed by finding live lice, as eggs take 7 days to hatch and may appear viable for weeks after death of the egg. Infestation may be more likely in school children, with risks increased in children with more siblings, longer hair, and of lower socioeconomic group.
METHODS AND OUTCOMES
We conducted a systematic review and aimed to answer the following clinical question: What are the effects of treatments for head lice? We searched: Medline, Embase, The Cochrane Library, and other important databases up to June 2008 (Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA).
RESULTS
We found 15 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions.
CONCLUSIONS
In this systematic review we present information relating to the effectiveness and safety of the following interventions: dimeticone, herbal and essential oils, insecticide combinations, lindane, malathion, mechanical removal by combing ('bug busting'), oral trimethoprim-sulfamethoxazone (co-trimoxazole, TMP-SMX), permethrin, phenothrin, and pyrethrum.
Topics: Administration, Oral; Animals; Humans; Lice Infestations; Malathion; Pediculus; Permethrin; Scalp Dermatoses; Treatment Outcome; Trimethoprim, Sulfamethoxazole Drug Combination
PubMed: 19445766
DOI: No ID Found -
Giornale Italiano Di Dermatologia E... Apr 2020Pthirus pubis, popularly known as crab louse, usually infests the pubis, groin, buttocks, intergluteal fold and perianal region. However, it can also infest, in... (Review)
Review
Pthirus pubis, popularly known as crab louse, usually infests the pubis, groin, buttocks, intergluteal fold and perianal region. However, it can also infest, in particular in hairy males or when the infestation is longstanding, the thighs, abdomen, chest, axillae and face. The involvement of the scalp is very rare. Eyelashes may also be involved. We present a review of the literature about etiology, epidemiology, clinical features, complications and therapy of Pthiriasis of the eyelashes.
Topics: Animals; Eyelashes; Humans; Lice Infestations; Phthirus
PubMed: 31525840
DOI: 10.23736/S0392-0488.19.06350-8