Pediculosis Capitis (Head Lice)

Figure 4.38 A: Scabies* B: Body lice in clothing* C: Pediculosis capitis* *Courtesy of Dr. Paul Getz
Figure 4.38
A: Scabies*
B: Body lice in clothing*
C: Pediculosis capitis*
*Courtesy of Dr. Paul Getz
(Figure 4.38C)
  • Due to Pediculus humanus capitis, a bloodsucking, wingless insect
  • Feeds every 4–6 h; female lays 5–10 eggs/day close to scalp, cemented to hair
  • Presents as scalp pruritus with nits commonly found behind ears and at nape of neck
  • Treatment: two applications 1 week apart of pediculicide
    • Malathion: organophosphate, flammable
    • Lindane: organochloride, not first line, neurologic toxicity (seizures, confusion, etc.)
    • Permethrin: synthetic pyrethroid, resistance high
    • Pyrethrin: naturally occurring pyrethroid extract, resistance high
   
 
Pyrethrins: derived from chrysanthemum flower
(so contraindication if allergic to ragweed or chrysanthemums)