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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 Journal of Health-system... Jul 2018Published literature describing the use of oral ivermectin for the treatment of head lice infestation is reviewed. (Review)
Review
PURPOSE
Published literature describing the use of oral ivermectin for the treatment of head lice infestation is reviewed.
SUMMARY
In the United States and globally, head lice infestation, or pediculosis capitis, remains a public health issue with both social and medical implications. Treatment with oral or topical medications is typically required for head lice eradication. Resistance to traditional topical therapies for head lice infestation is increasing, creating a need for consideration of additional treatment options. A growing body of data describing the potential role of oral ivermectin for the treatment or prevention of head lice infestation is available. A literature search identified 5 clinical trials that evaluated safety and/or effectiveness outcomes of oral ivermectin use as an alternative to malathion, other topical prescription medications, and traditional, nonprescription remedies; those studies were conducted in various parts of the world (e.g., Australia, Brazil, Mexico, Egypt) and likely involved varying types and degrees of lice resistance. Clinical research findings to date, while not consistently robust, suggest that oral ivermectin is comparable or superior in effectiveness to other topical treatment options for head lice infestation while being well tolerated and favorably perceived by patients and caretakers.
CONCLUSION
Oral ivermectin is an option for the treatment of head lice infestation, especially in individuals who have experienced a treatment failure. Published evidence from clinical trials indicates that oral ivermectin is as effective as currently available topical treatments.
Topics: Administration, Oral; Animals; Humans; Insecticide Resistance; Insecticides; Ivermectin; Lice Infestations; Pediculus
PubMed: 29789316
DOI: 10.2146/ajhp170464 -
Pediatrics Oct 2022Head lice infestation is associated with limited morbidity but causes a high level of anxiety among caregivers of school-aged children and adolescents. Since the 2015...
Head lice infestation is associated with limited morbidity but causes a high level of anxiety among caregivers of school-aged children and adolescents. Since the 2015 clinical report on head lice was published by the American Academy of Pediatrics, new medications have been approved, and an algorithm for management of affected patients is included. This revised clinical report clarifies current diagnosis and treatment protocols.
Topics: Adolescent; Animals; Caregivers; Child; Humans; Lice Infestations; Pediculus; Scalp Dermatoses
PubMed: 36156158
DOI: 10.1542/peds.2022-059282 -
Journal of the American Academy of... Mar 2020Pediculosis is an infestation of lice on the body, head, or pubic region that occurs worldwide. Lice are ectoparasites of the order Phthiraptera that feed on the blood... (Review)
Review
Pediculosis is an infestation of lice on the body, head, or pubic region that occurs worldwide. Lice are ectoparasites of the order Phthiraptera that feed on the blood of infested hosts. Their morphotype dictates their clinical features. Body lice may transmit bacterial pathogens that cause trench fever, relapsing fever, and epidemic typhus, which are potentially life-threatening diseases that remain relevant in contemporary times. Recent data from some settings suggest that head lice may harbor pathogens. The epidemiology, clinical manifestations, and management of body, head, and pubic louse infestation are reviewed. New therapies for head lice and screening considerations for pubic lice are discussed. Tungiasis is an ectoparasitic disease caused by skin penetration by the female Tunga penetrans or, less commonly, Tunga trimamillata flea. It is endemic in Latin America, the Caribbean and sub-Saharan Africa and seen in travelers returning from these regions. Risk factors for acquiring tungiasis, associated morbidity, and potential strategies for prevention and treatment are discussed.
Topics: Animals; Endemic Diseases; Ill-Housed Persons; Humans; Insecticides; Lice Infestations; Mass Screening; Pediculus; Phthirus; Risk Factors; Scalp Dermatoses; Travel-Related Illness; Tunga; Tungiasis
PubMed: 31306729
DOI: 10.1016/j.jaad.2019.05.110 -
Veterinary Parasitology, Regional... Jan 2020The present survey was carried out during autumn 2013 (September, October and November) in five localities of Jendouba district. A total number of 300 donkeys were...
The present survey was carried out during autumn 2013 (September, October and November) in five localities of Jendouba district. A total number of 300 donkeys were examined and all present ectoparasites found on animals were collected and examined under stereomicroscope. The infestation rate by lice was estimated to 12.7% (38/300) there was no difference between infestation rates in males (11.5%; 22/192) and females (14.8%; 16/108). The highest infestation rate was observed in donkeys aged between 10 and 14 years, they represented 19.6% of the infested donkeys. Two lice species were collected with no statistically difference between the two infestation rates: Haematopinus asini (4%; 12/300) and Bovicola ocellatus (5.3%; 16/300). The lice were collected from donkeys of the five regions with no statistically difference between the infestation rates. A specific programme to control these parasites is recommended to improve the welfare of the working donkeys in Tunisia and in other North African countries.
Topics: Animals; Anoplura; Equidae; Female; Ischnocera; Lice Infestations; Male; Prevalence; Tunisia
PubMed: 32057395
DOI: 10.1016/j.vprsr.2019.100368 -
Seminars in Cutaneous Medicine and... Sep 2014Pediculosis (capitis, corporis, and pubis) share well-known features: worldwide prevalence (involving millions of people annually); parasites inducing skin lesions... (Review)
Review
Pediculosis (capitis, corporis, and pubis) share well-known features: worldwide prevalence (involving millions of people annually); parasites inducing skin lesions directly, and indirectly as a result of itching and hypersensitivity to parasites; and treatment based on good entomological knowledge of the parasite and practical considerations (ie, most available treatments do not act on eggs and should be repeated, depending on the life cycle of the parasites). Infestations are spread most commonly by close contacts. Social stigma and persistent misconceptions complicate the implementation of appropriate management strategies. Head and pubic lice infestations are diagnosed by the visualization of insects or viable nits (eggs). Primary treatments are topical pediculicides (permethrin or malathion), used twice, but emergence of resistance against pediculicides has created the need of alternative treatments including topical or oral ivermectin. 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. Environmental treatment is also necessary for the eradication of the infestation. Health care personnel who come into contact with this population need to be well informed of the facts in order to disseminate accurate information for diagnosis and management.
Topics: Animals; Chrysanthemum cinerariifolium; Cross-Sectional Studies; Drug Resistance; Hexachlorocyclohexane; Humans; Insecticides; Ivermectin; Lice Infestations; Malathion; Pediculus; Permethrin
PubMed: 25577849
DOI: 10.12788/j.sder.0105 -
Pediatrics May 2015Head lice infestation is associated with limited morbidity but causes a high level of anxiety among parents of school-aged children. Since the 2010 clinical report on...
Head lice infestation is associated with limited morbidity but causes a high level of anxiety among parents of school-aged children. Since the 2010 clinical report on head lice was published by the American Academy of Pediatrics, newer medications have been approved for the treatment of head lice. This revised clinical report clarifies current diagnosis and treatment protocols and provides guidance for the management of children with head lice in the school setting.
Topics: Animals; Child; Humans; Lice Infestations; Pediculus
PubMed: 25917986
DOI: 10.1542/peds.2015-0746 -
Pediatrics Aug 2010Head lice infestation is associated with limited morbidity but causes a high level of anxiety among parents of school-aged children. Since the 2002 clinical report on...
Head lice infestation is associated with limited morbidity but causes a high level of anxiety among parents of school-aged children. Since the 2002 clinical report on head lice was published by the American Academy of Pediatrics, patterns of resistance to products available over-the-counter and by prescription have changed, and additional mechanical means of removing head lice have been explored. This revised clinical report clarifies current diagnosis and treatment protocols and provides guidance for the management of children with head lice in the school setting.
Topics: Animals; Child; Child, Preschool; Female; Humans; Lice Infestations; Male; Pediatrics; Pediculus; Practice Guidelines as Topic; Practice Patterns, Physicians'; United States
PubMed: 20660553
DOI: 10.1542/peds.2010-1308 -
Diseases of Aquatic Organisms Sep 2023Sea lice are a key limitation to sustainable salmon aquaculture, and effective monitoring strategies are critical for the management of these parasites. Sentinel cages...
Sea lice are a key limitation to sustainable salmon aquaculture, and effective monitoring strategies are critical for the management of these parasites. Sentinel cages are an established means of assessing infestation pressure at fixed locations, but as smolts move through systems they will be exposed to varying lice densities. As a means of assessing infestation pressure along trajectories, we describe the development and application of towed sentinel cages (TSCs) in a Scottish sea loch containing salmonid aquaculture. Trial deployments took place over 3 yr (2016-2018), and levels of sea lice infestation were compared between methodologies. Oceanographic data was collected alongside TSCs to put the results into the environmental context that smolts and sea lice experienced during the tows. The sea lice infestation rates found from TSCs were comparable to those on contemporaneously deployed fixed sentinel cages. Thus, due to their practicability and consistency with other surveillance methods, TSCs could be used to improve the assessment of exposure risk along wild salmonid smolt migration trajectories, where these are known.
Topics: Animals; Salmo salar; Copepoda; Lice Infestations; Aquaculture
PubMed: 37706647
DOI: 10.3354/dao03748 -
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