Skin Diseases

ٰLICE

Head Lice

Infestation with the head louse, Pediculus humanus capitis,  is common. It is highly contagious and spread by direct head-to-head  contact. Scalp itch leads to scratching, secondary infection and cervical lymphadenopathy. The diagnosis is confirmed by identifying the living louse or nymph on the scalp or on a  black sheet of paper after careful fine-toothed  combing of wet hair  following conditioner  application. The empty egg cases (‘nits’)  are easily seen on the hair shaft  and are hard to dislodge.

Treatment

Treatment  is recommended  for the affected  individual and many infected  household\ school contacts.Eradication  in school population is difficult because of poor compliance  and treatment resistance.Malathion, premethrin or carbaryl, in lotion or aqueous formulations,  should be applied twice at an interval of 7-10 days. Rotation  treatments within a  community  may avoid  resistance. Regular ‘wet-combing’ (physical removal of live lice by regular combing of conditioned wet hair)  may be less effective than pharmacological  treatments. Vaseline  should be applied to eyelashes\ brows twice  daily for at least  a fortnight.

Body lice

These  are similar to head lice  but live on clothing,  particularly in seams,  and feed on the skin. Poor hygiene and  overcrowded conditions predispose. Itch,excoriation and secondary infection occur. Dry cleaning and high temperature washing or insecticide  treatment of clothes are required.

Pubic (crab) lice

Usually,  these are sexually acquired  and very itchy. Malathion or carbaryl in an aqueous base  easy treatment of choice,  applied on two occasions  to the whole body, as body hair can also be infested. Contacts  should  also be treated.

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