Lice (Pediculosis)

Question 1

What is the clinical presentation of lice?

Answer 1

Intensely pruritic red excoriations (can’t stop picking at the skin), morbiliform rash (measles like rash) caused by lice

Scalp lice - on hair, red, excoriated skin with secondary bacterial infection, lymphadenopathy

Body lice - nits and lice ion seams of clothes, excoriations and secondary infection mainly on shoulders, belt line and buttocks

Question 2

What is the aetiology of lice?

Answer 2

Attaches to body hair and feeds, can transmit infectious agents such as bartonella Quintana and rickettsia prowazekii

Question 3

What is the d/d for lice?

Answer 3

Bacterial infection of scalp, seborrheic dermatitis

Question 4

What is the diagnosis for lice?

Answer 4

Visible upon infection of affected area or clothing seams

Question 5

What is the management for lice?

Answer 5

Permethrin 1% cream or permethrin 1% shampoo
Comb hair with fine toothed comb using diluted vinegar solution to remove nits
Repeat in 7 days after 1st treatment
Shave hair if possible, change clothing and linens, wash with detergent in hot water cycle then machine dry