PEDICULOSIS

PUBIS
READING ASSIGNMENT

H E DW I K A A DV I N A N A S T I T I
 Anoplura à 400 species of sucking
lice

Sucking lice
• dorsoventrally compressed,
PUBIC LICE • wingless, and small,
• retractable piercing-sucking mouthparts.

Three species of lice infest human

beings:
• Phthirus pubis, the crab louse;
• Pediculus humanus humanus, the body louse;
• Pediculus humanus capitis, the head louse.
 • Israeli scientists confirmed that the
warriors in Bar Kochba’s Jewish revolt
against Rome 18 centuries ago were
afflicted with lice.
• These lice were morphologically identical
HISTORY to P. capitis (Anaplura: Pediculidae) that
continue to afflict human populations
today.
• The lice were discovered in the hair and
clothes of archeological remains from
caves in the Sudan desert.
LIFE CYCLE AND
REPRODUCTION
• Five stages in the life cycle: egg (or nit),
three nymphal stages, and the adult stage
à All stages occur on the host.
• Immature lice are morphologic
miniatures of adults à no reproductive
ability.
• The egg of the crab louse is
approximately 0.8 mm long and 0.3 mm
wide.
• The nit is oval in shape and opalescent in
color; it contains a cap (operculum) that
comes off intact when the egg hatches.
Close-up micrograph of a louse nit (egg)
• An egg will hatch within 5-10 days after
being incubated in the heat of the host’s
body.
• Over a period of 8-9 days, the nymph
produces three molts.
• The louse remains on the body and
requires frequent blood meals after
having hatched.
• When lice reach adulthood, mating
occurs after approximately 10 hours
and continues until the lice die.
• The female louse lays approximately
four eggs per day.
• Under artificial conditions, lice have survived for about 1
month
• Off the host, all stages of the louse can be expected to die
within 30 days, regardless of temperature.
• Unfed adult head and body lice can survive for up to 10
days, adult pubic lice rarely survive more than 24 hours off
the host.
• Lice leave the host voluntarily only when the host has
died or becomes febrile or when there is close personal
contact with another host.
• The life of the louse is dependent on human blood.
• When ready to feed, the louse anchors its mouth to
the skin à stabs an opening through the skin à pours
saliva into the wound to prevent clotting à and
pumps blood from the wound into its digestive
system.
• During feeding, dark-red feces may be deposited on
the skin.
• Pubic lice may be found not only in the pubic area,
but also have been recovered from the axillae,
beard areas of the face, eyelashes, and eyebrows à
it is probably mechanically moved to these areas
via the fingers.
 Body Glue the eggs Moving
Head Longer body hairs -
lice
Body Longer body on the fiber/ 35mm in 2
lice clothing hour
Pubic Abdomen is hairs 10cm/day
lice wider than it is
long
Pubic louse after a recent blood meal
 EPIDEMIOLOGY AND TRANSMISSION
• Infestations with pubic lice are more common in people
of low socioeconomic status.
• Sexual transmission is considered the most important
means of pubic lice transmission.
• However, there are documented cases of transmission
from toilet seats, beds, and egg-infested loose hairs
dropped by infested persons on shared objects.
• The population with the highest incidence of pubic
lice is similar to that of gonorrhea and syphilis:
– single persons,
– ages 15-25 years.

• Prevalence of pubic lice infestation declines gradually

to age 35 and is rare in persons older than age 35
CLINICAL MANIFESTATIONS

When previously unexposed persons are bitten, there may either be no

signs or symptoms or a slight sting with little or no itching or redness.

At least 5 days must pass before allergic sensitization can occur.

The main symptom à itching à scratching, erythema, irritation, and

inflammation.

An individual who has been bitten by a large number of lice over a short
period may have mild fever, malaise, and increased irritability.
Excessive scratching may lead to
superinfection.

Characteristic small blue spots

à as a result of the crab louse
bites; these persist for several
days.

A tubo-ovarian inflammatory
mass attributed to P. pubis has
been reported.
 DIAGNOSIS

(1) taking a careful history from the patient

(2) considering lice infestation as a possible or

probable cause of the patient’s signs and symptoms,

(3) careful examination of the patient.

Examination of the groin or pudendal area à
if nits appear on the hairs, the proper
diagnosis becomes obvious.

When no adult lice are available, the

demonstration of nits under the microscope
will also confirm the diagnosis.

dd/ seborrheic dermatitis (dandruff flakes),

hair casts, solidified globules of hair spray, and
certain accretions on hair shafts.
 MANAGEMENT
• All bedding, towels, clothing should be washed.
• Some patients require a second application of
topical therapy in 3-7 days after initial treatment.
• Infestation of eyelashes à occlusive ointment
(petroleum jelly) 2x/day for 10 days
• Other agents for P. pubis à 0,5% malathion, 0,5-1%
carbaryl, 0,2% phenothrin
•
Thank you