DR6.1 | Pediculosis Diagnosis and Management — Summary & Reflection

KEY TAKEAWAYS

Pediculosis occurs in three forms. Pediculosis capitis (head louse) affects mainly school children, is diagnosed by live lice and cemented nits within 1 cm of the scalp, and is treated first-line with permethrin 1% (repeated in 7-10 days), with malathion 0.5% second-line and wet-combing as adjunct. Pediculosis corporis (body louse) lives in clothing seams not on skin, is managed chiefly by decontaminating clothing and bedding, and is the vector of epidemic typhus, louse-borne relapsing fever and trench fever. Pediculosis pubis (crab louse) is a sexually transmitted infestation needing partner treatment and STI screening, with eyelash involvement managed by white soft paraffin and, in a child, prompting safeguarding review. Across types, counsel that permethrin causes irritation, malathion is flammable and malodorous, and ivermectin needs caution in children under 15 kg and pregnancy; in children prefer permethrin and wet-combing and allow school return after the first treatment.

REFLECT

Recall how head lice were handled in a school or family you know — was a child kept out of school for days over harmless hatched nits, or a family made to feel dirty over an infestation that has nothing to do with hygiene? Reflecting on how stigma and outdated 'no-nit' rules cause more harm than the lice themselves, write down how you would explain a head-lice diagnosis to an anxious parent in two sentences, and note for yourself the one extra question you must always ask when the louse is a body louse, and the one when it is a pubic louse.