Pediculosis Body

What is Pediculosis Body?

Body pediculosis is a rare ectoparasitic disease manifested by itchy skin lesions at the site of louse bites, often accompanied by secondary infection, eczematization, and other complications.

Causes of Pediculosis Body

The causative agent of body lice is a body louse (Pediculus humanus corporis).

Pathogenesis during Pediculosis Body

Lice feed exclusively on human blood, piercing the skin, squirting saliva and then sucking the blood. A mature adult female lays 3-6 eggs (nits) per day. Nits have a length of 0.8 mm, white color and seem attached to the base of the hair. They are displayed in 8-10 days and reach maturity in 8-18 days. Adult louse lives 9-10 days. Nits can live 3 weeks outside the host’s body. Crowding and lack of conditions for personal hygiene contribute to the wide spread of infection.

Females of clothes louse, laying eggs (nits) stick them to the linen, clothes. Larvae hatch from eggs, turning into adult lice. The whole development cycle takes place on the host and lasts at least 20 days. Adult lice live 27-46 days. The length of the eggs – 0, 6-1 mm, the length of adult lice 1-5 mm.

The body louse is a carrier of causative agents of epidemic typhus and epidemic relapsing (lousy) typhus, trench fever.

Body lice spread, crawling from person to person, mainly through close contact of people. The clothes louse lives in folds and seams of linen. When the lice is very stitched, lice can spread out on outerwear, bedding, furnishings, and sex.

The spread of body lice usually occurs in violation of hygienic standards of life (irregular washing, a rare change of underwear and bed linen), which is associated with a low cultural level of a certain part of the population or various social and natural disasters.

Symptoms of Pediculosis Body

Pediculosis is rarely observed when hygiene rules are observed. Adult lice live and lay eggs in the seams of clothing (usually in the folds of underwear).

Small cone-shaped papules form at the site of biting lice, mainly on the skin of the neck, back, lumbar, skin becomes dry, coarse, thickens, and pigmentation appears. Lice bites are accompanied by itching, which can lead to scratching; infection with scratching may develop pyoderma.

The most common symptom is itching, leading to scratching and, in later stages, to inflammation. Uninfected bites look like red bumps 2-4 mm in diameter with a red base. On examination revealed red dots 2-4 mm in diameter. Sometimes pediculosis is complicated by furunculosis.

Diagnosis of Pediculosis Body

An accurate diagnosis requires detection of lice or live nits. You can use the fluorescence method under the Wood’s lamp (which all dermatologists use when recognizing trichomycosis and other dermatoses). Live nits fluoresce a bluish color, and the dead do not shine and appear to be gray and dull on direct examination.

In the differential diagnosis take into account the possible similarity with pediculosis, pediculosis eczema and other complications of pediculosis; also with pruritus, diabetic pruritus, senile pruritus, seborrheic eczema, microbial eczema, atopic dermatitis, strophulyus (so-called pediatric scab), senile prurigo, urticaria, deprived of Vidal (limited neurodermatitis), zyxphenosis, urticaria, deprived of vidal (limited neurodermatitis) , streptostaphiloderma, staphyloderma), blepharitis and conjunctivitis, not associated with phthiriasis, melasma of endocrine or toxic origin, damped syphilitic roseola. Diagnosis includes a mandatory inspection of contact persons.

Body Pediculosis Treatment

In case of ward pediculosis, sanitary treatment is performed (they wash the body with hot water and soap) and at the same time the disinsection of linen, outerwear, bedding and residential premises. Disinsection of linen, outerwear and bedding is carried out in the disinsection chambers, and in the absence of them – insecticides. The latter are applied to the surface of things (bedding, outerwear) using hand-sprayers or sprayers or soaked in an emulsion (underwear and bed linen). Use 0, 15% aqueous emulsion of karbofos, for the preparation of which to 3 g of 50% or 5 g of 30% emulsifiable concentrate of karbofos add 1 liter of warm water; 0, 06% aqueous emulsion of sulfidophos, for the preparation of which to 1, 2 g of 50% emulsifiable concentrate of sulfadophos add 1 liter of warm water; 20% aqueous soap-kerosene emulsion; 5% methyl acetate or pyrethrum powder. For soaking one set of underwear consumed 2, 5 liters of emulsion, one set of bed linen – 4-4, 5 liters (exposure using an aqueous emulsion for 20-30 minutes, sulfidophos – 5-10 minutes), for irrigating one set of outer clothing – 350 ml, bedding – 400 ml. Processed things can be used after drying and airing. When processing powders on one set of underwear consumes 25 g of methyl acetate dust, 30-55 g of pyrethrum; one set of bedding – 40 g of methyl acetophos dust, 60 g of pyrethrum; on one set of outerwear – 40 g of methyl acetate acetate, 105 g of pyrethrum. After that, things are bagged; After 2-3 hours, dust is shaken or removed from things with a vacuum cleaner and things are aired until the smell of the preparation disappears.

For the destruction of lice in the premises (on the floor) and on the furnishings used liquid or powdered insecticides. Based on 1 m2 of space, 50-100 ml of a 0.5% aqueous solution of chlorophos are used (6 g of 80% of technical chlorophos is diluted with warm water to 1 l) or 15 g of 5% of methyl acetophos or pyrethrum powder. For the treatment of premises are also used aerosol cans “Neofos-2” and “Carbozol”. Depending on the capacity of the cylinders (120 or 180 g), 15-20 m2 of area is treated. After 2 h after treatment, the room is ventilated for 3 h, and then wet cleaning is carried out.

Modern insecticides that act as neurotoxic poisons on lice include:
1) organophosphorus compounds (malathion);
2) aromatic hydrocarbons (crotamiton, benzyl benzoate);
3) halogenated hydrocarbons (lindane);
4) advanced pyrethrins and synthetic pyrethroids (permethrin, A-Par, etc.).

In each country, a preferred drug is selected from this list. In the US, lindane is considered the cheapest, and permethrin is considered safe and effective. In Russia, they are prescribed by doctors and are available in pharmacies mainly preparations of synthetic pyrethroids, permethrin in the preparations Nittifor, Medifox, and others (Clinical guidelines, 2007). Benzyl benzoate (with contraindications to pyrethroids) is less commonly recommended, and old products (with kerosene for head lice, “Simple Sulfur Ointment” for smooth skin, mercury ointment for the treatment of phthyriasis) are not used now because of their inconvenience and irritation.

Pyrethroids are esters of chrysanthemum acids and various cyclic alcohols with minimal toxic and irritant effects. They can cause allergic dermatitis in rare cases of cross-hypersensitivity to plants of the genus Chrysanthemum.

Nittifor is effective and convenient in application (50 mg of permethrin in 10 ml of a solution of distilled water and ethyl alcohol). The hair is plentifully moistened with a solution, rubbing it with a cotton swab: 10–60 ml per person is required (then the head is covered with a handkerchief, the medium is washed off after 40 minutes, combed hair and remove the dead lice). Do not get the solution into the eyes, mucous membranes. After treatment, the hands are thoroughly washed, the mouth rinsed. To remove the nits, the hair is treated with a 3% solution of acetic acid, then combed out with a frequent comb after 1 hour. After a week, the patient is examined – if lice are found, they are re-treated.

Medifox also contains permethrin in a 5% or 20% solution (Medifox-super). In a vial with 2 ml of a 5% solution, 30 ml of water are added, the resulting emulsion is applied to wet hair, washed off after 20 minutes.

Aerosol preparation “Para Plus” contains 0.58 g of permethrin, 0.29 g of malateon, 2.32 g of piperonyl butoxide in 116 g of the composition. Organophosphate malathion complements the insecticidal effect by acting on insects at the level of the motor nerves, forming a covalent bond with cholinesterase. Piperonyl butoxide blocks the protective enzymes of lice, which allows to reduce the concentration of insecticide, without reducing its effectiveness. Piperonyl butoxide is also included in the A-Par aerosol formulation. Aerosol preparations are contraindicated in bronchial asthma.

The drug “A-Par” (esdepaletrin with peritonil butoxide) is used to disinfect clothes and bedding that are not subject to soaking and boiling. The room and furniture are wiped with Medifox-super (10 ml of concentrate and 990 ml of water) or spray A-Par. The linen can be soaked in Medifox-super solution (for 40 minutes); after rinsing, keep soda ash (1 tablespoon per 1 l of water) in the solution for 24 hours, then wash. Clothing can be irrigated with Medifox through a nebulizer.

For the treatment of pyogenic complications, antimicrobial ointments are recommended, for lymphadenitis – inside Trimethoprim / Sulfamethoxazole or Doxycycline inside.

Prognosis for pediculosis
With adequate treatment, over 90% of patients recover. Relapses are often noted with repeated infection and incomplete treatment.

Prevention of Pediculosis Body

For personal prophylaxis, regular change of linen and clothes, frequent washing of the head and body are necessary; stranger bedding should be avoided. Call your doctor in a timely manner. Public events include inspections in some groups – kindergartens, schools, student dormitories, as well as conducting disinfection in rooms, monitoring the correctness and results of treatment, promotion of sanitary knowledge. When a case of pediculosis is detected, examination and treatment of persons who have been in contact with a pediculine patient (in a family, school, kindergarten) is necessary.