Chapter 60
Pediculosis and Cimicosis
Sandipan Dhar,
Sahana M. Srinivas,
Sandipan Dhar
Department of Pediatric Dermatology, Institute of Child Health, Kolkata, West Bengal, India
Search for more papers by this authorSahana M. Srinivas
Department of Pediatric Dermatology, Indira Gandhi Institute of Child Health, Bangalore, Karnataka, India
Search for more papers by this authorSandipan Dhar,
Sahana M. Srinivas,
Sandipan Dhar
Department of Pediatric Dermatology, Institute of Child Health, Kolkata, West Bengal, India
Search for more papers by this authorSahana M. Srinivas
Department of Pediatric Dermatology, Indira Gandhi Institute of Child Health, Bangalore, Karnataka, India
Search for more papers by this authorBook Editor(s):Peter Hoeger,
Veronica Kinsler,
Albert Yan,
John Harper,
Arnold Oranje,
Christine Bodemer,
Margarita Larralde,
David Luk, Vibhu Mendiratta,
Diana Purvis,
Peter Hoeger
Search for more papers by this authorVeronica Kinsler
Search for more papers by this authorAlbert Yan
Search for more papers by this authorJohn Harper
Search for more papers by this authorArnold Oranje
Search for more papers by this authorChristine Bodemer
Search for more papers by this authorMargarita Larralde
Search for more papers by this authorVibhu Mendiratta
Search for more papers by this authorDiana Purvis
Search for more papers by this authorFirst published: 20 November 2019
Summary
Pediculosis, a worldwide infestation seen in all age groups, poses a significant health concern in the paediatric age group. Pediculosis is caused by blood-sucking, wingless insects of the order Phthiraptera. Humans are infested with three common types: pediculosis capitis caused by Pediculosis humanus var. capitis; pediculosis corporis caused by Pediculosis humanus var. humanus; and pediculosis pubis caused by Phthirus pubis. Pediculosis capitis is seen more commonly in children, especially in those of school age. Pediculosis capitis manifests as pruritus, excoriation, papules, scaling, haemorrhagic crusts, an eczematous reaction, pyoderma, matted hair (plica polonica) and secondary lymphadenopathy. Pediculosis corporis and pediculosis pubis are rarely seen in children. Diagnosis of pediculosis is mainly clinical, but usually confirmed by the presence of nits firmly attached to scalp hairs. The synthetic pyrethroid permethrin is the first line of treatment in pediculosis. There is emerging resistance to various topical treatments, but the true prevalence is not known. Screening and treatment of all close contacts is necessary for successful treatment of pediculosis.
The prevalence of cimicosis (bedbug infestations) has been increasing, particularly in developing countries. Bedbugs are obligate blood parasites. Among them, Cimex lectularius (common bedbug) and Cimex hemipterus (tropical bedbug) feed on humans. Bedbugs hide in cracks and crevices of furniture during the day and feed at night. Bedbug infestation is highly prevalent in homeless shelters and school hostels. The exact prevalence of bedbug infestation in children is not known. Infestation is clinically manifest as macules, papules, vesicles, bullae, wheals or targetoid lesions either in clusters or in a linear pattern distributed on the face, trunk and extremities. Diagnosis is based on history and the classic appearance of the bite reaction. Bedbug bites are usually self-limiting. Counselling parents, removing infested furniture and judicious use of insecticides form the mainstay of management.
References
-
Pernet G. An historical note on the nits of the body louse. Br J Dermatol 1918; 30: 208.
10.1111/j.1365-2133.1918.tb12381.x Google Scholar
- Araujo A, Ferreria LF, Guidon N et al. Ten thousand years of head lice infection. Parasitol Today 2000; 16: 269.
-
Driver GR. Lice in the Old Testament. Palestine Exploration Quarterly 1974; 106: 159–60.
10.1179/peq.1974.106.2.159 Google Scholar
- Grinnell ME, Hawes IL. Bibliography on lice and man with particular reference to wartime condition, Washington DC. Bibliogr Bull 1, US Dept. Agriculture; 1943.
- Mumcuoglu KY, Barker SC, Burgess IE et al. International guidelines for effective control of head louse infestations. J Drugs Dermatol 2007; 6: 409–14.
- Cazorla D, Ruiz A, Acosta M. Clinical and epidemiological study of pediculosis capitis in schoolchildren from Coro, Venezuela. Invest Clin 2007; 48: 445–57.
- Jahnke C, Bauer E, Feldmeier H. Pediculosis capita in childhood: epidemiological and socio-medical results from screening of school beginners. Gesundheitswesen 2008; 70: 667–73.
- Soultana V, Euthumia P, Antonios M, Angeliki RS. Prevalence of pediculosis capitis among school children in Greece and risk factors: a questionnaire survey. Pediatr Dermatol 2009; 26: 701–5.
- Toloza A, Vassena C, Gallardo A et al. Epidemiology of Pediculosis capitis in elementary schools of Buenos Aires, Argentina. Parasitol Res 2009; 104: 1295–8.
- Omidi A, Khodaveisi M, Moghimbeigi A. Pediculosis capitis and relevant factors in secondary school students of Hamadan, West of Iran. J Res Health Sci 2013; 13: 176–80.
- Falagas ME, Matthaiou DK, Rafaillidis PI et al. Worldwide prevalence of head lice. Emerg Infect Dis 2008; 14: 1493–4.
- Vahabi A, Shemshad K, Sayyadi M et al. Prevalence and risk factors of Pediculus (humanus) capitis (Anoplura: Pediculidae), in primary schools in Sanandaj city, Kurdistan Province, Iran. Trop Biomed 2012; 29: 207–11.
- Moosazadeh M, Afshari M, Keianian H et al. Prevalence of head lice infestation and its associated factors among primary school students in Iran: A systemic review and meta-analysis. Osong Public Health Res Perspect 2015; 6: 346–56.
- Khokhar A. A study of pediculosis capitis among primary school children in Delhi. Indian J Med Sci 2002; 56: 449–52.
- Sharma NL, Sharma RC. Prevalence of dermatologic diseases in school children. Indian J Dermatol Venereol Leprol 1990; 56: 375–6.
- Harris J, Crawshaw JG, Millership S. Incidence and prevalence of head lice in a district health authority area. Common Dis Public Health 2003; 6: 246–9.
- Hazrati Tappeh K, Chavshin AR, Mohammadzadeh Hajipirloo H et al. Pediculosis capitis among primary school children and related risk factors in Urmia, the main city of West Azerbaijan, Iran. J Arthropod Borne Dis 2012; 6: 79–85.
-
Meinking TL. Infestations. Curr Probl Dermatol 1999; 11: 73–120.
10.1016/S1040-0486(99)90005-4 Google Scholar
- Saurabh S, Sahu SK, Sadishkumar A et al. Screening for skin diseases among primary school children in a rural area of Puducherry. Indian J Dermatol Venereol Leprol 2013; 79: 268.
- AlBashtawy M, Hasna F. Pediculosis capitis among primary-school children in Mafraq Governorate, Jordan. East Mediterr Health J 2012; 18: 43–8.
- Mumcuoglu KY, Klaus S, Kafka D et al. Clinical observation related to head lice infestation. J Am Acad Dermatol 1991; 25: 248–51.
- Slonka GF, Fleissner ML, Berlin J et al. An epidemic of pediculosis capitis. J Parasitol 1977; 63: 377–83.
- Bonilla DL, Durden LA, Eremeeva ME, Dasch GA. The biology and taxonomy of head and body lice–implications for louse-borne disease prevention. PLoS Pathog 2013; 9: e1003724.
- Klaus S, Shvil Y, Mumcuoglu KY. Generalized infestation of a 3½ year old girl with the pubic louse. Pediatr Dermatol 1994; 11: 26–8.
- Poudel SK, Barker SC. Infestation of people with lice in Kathmandu and Pokhara, Nepal. Med Vet Entomol 2004; 18: 212–13.
- Ryan MF. Phthiriasis palpebrarum infection: a concern for child abuse. J Emerg Med 2014; 46: e159–62.
- Durden LA, Musser GG. The sucking lice (Insecta: Anoplura) of the world: a taxonomic checklist with records of mammalian hosts and geographical distributions. Bull Am Mus Nat Hist 1994; 218: 1–90.
- Nutanson, I, Steen CJ, Schwartz RA, Janniger CK. Pediculus humanus capitis: an update. Acta Dermatoven APA 2008; 17: 147–59.
- Jones KN, English JC III. Review of common therapeutic options in the United States for the treatment of pediculosis capitis. Clin Infect Dis 2003; 36: 1355–61.
- Frankowski BL, Weiner LB, American Academy of Pediatrics, Committee on School Health, Committee on Infectious Diseases. Head lice. Pediatrics 2000; 110: 638–43.
- Mumcuoglu KY, Miller J, Gofin R et al. Epidemiological studies on head lice infestation in Israel. 1. Parasitological examination of children. Int J Dermatol 1990; 29: 502–6.
- Burke S, Mir P. Pediculosis causing iron deficiency anaemia in school children. Arch Dis Child 2011; 96: 989.
- Charfi F, Ben Zina Z, Maazoun M et al. Phthiriasis pubis palpebrarum in children. Diagnosis and treatment. J Fr Ophtalmol 2005; 28: 765–8.
- Scott MD, Esterly NB. Eyelash infestation by Phthirus pubis as a manifestation of child abuse. Pediatr Emerg Care 1983; 1: 179.
- Mumcuoglu KY, Friger M, Ioffe-Uspensky I et al. Louse comb versus direct visual examination for the diagnosis of head louse infestations. Pediatr Dermatol 2001; 18: 9–12.
- Zalaudek I, Argenziano G. Images in clinical practice. Dermoscopy of nits and pseudonits. N Engl J Med 2012; 367: 1741.
- Madke B, Khopkar U. Pediculosis capitis: An update. Indian J Dermatol Venereol Leprol 2012; 78: 429–38.
- Verma P, Namdeo C. Treatment of pediculosis capitis. Indian J Dermatol 2015; 60: 238–47.
- Tebruegge M, Runnacles J. Is wet combing effective in children with pediculosis capitis infestation? Arch Dis Child 2007; 92: 818–20.
- Dodd CS. Interventions for treating head lice. Cochrane Database Syst Rev 2001; 3: CD001165.
- Pollack RJ, Kiszewki A, Armstrong P et al. Differential permethrin susceptibility of head lice sampled in the United States and Borneo. Arch Pediat Adolesc Med 1999; 153: 969–73.
- Pe'er J, BenEzra D. Corneal damage following the use of the pediculicide A-200 pyrinate. Arch Dermatol 1988; 106: 16–17.
- Stough D, Shellabarger S, Quiring J, Gabrielsen AA. Efficacy and safety of Spinosad and Permethrin Creame rinses for pediculosis capitis (head lice). Pediatrics 2009; 124: 389–95.
- Dodd CS. Interventions for treating head lice. Cochrane Database Syst Rev 2001; CD001165.
- Bagavan A, Rahuman AA, Kamaraj C et al. Contact and fumigant toxicity of hexane flower bud extract of Syzygium aromaticum and its compounds against Pediculus humanus capitis (Phthiraptera: Pediculidae). Parasitol Res 2011; 109: 1329–40.
- Izri A, Uzzan B, Maigret M et al. Clinical efficacy and safety in head lice infection by Pediculus humanis capitis De Geer (Anoplura: Pediculidae) of a capillary spray containing a silicon-oil complex. Parasite 2010; 17: 329–35.
- Militão de Sousa F, Vasconcelos AW, de Nadon J, Duhot PY. Treatment of human head lice infestations in a single application with a new galenic lotion. Int J Cosmet Sci 2010; 32: 369–75.
- Choi HY, Yang YC, Lee SH et al. Efficacy of spray formulations containing binary mixtures of clove and eucalyptus oils against susceptible and pyrethroid/ malathion-resistant head lice (Anoplura: Pediculidae). J Med Entomol 2010; 47: 387–91.
- Heukelbach J, Sonnberg S, Becher H et al. Ovicidal efficacy of high concentration dimeticone: A new era of head lice treatment. J Am Acad Dermatol 2011; 64: e61–2.
- Burkhart CN, Burkhart CG. Oral ivermectin therapy for phthiriasis palpebrum. Arch Ophthalmol 2000; 118: 134–5.
- Witkowski JA, Parish LC. Pediculosis and resistance: the perennial problem. Clin Dermatol 2002; 20: 87–92.
- Bialek R, Zelck UE, Folster-Holst R. Permethrin treatment of head lice with Knockdown resistance–like gene. N Engl J Med 2011; 364: 386–7.
- Marcoux D, Palma KG, Kaul N et al. Pyrethroid pediculicide resistance of head lice in Canada evaluated by serial invasive signal amplification reaction. J Cutan Med Surg 2010; 14: 115–18.
References
- Usinger RL. Monograph of Cimicidae (Hemiptera-Heteroptera). College Park, MD: Entomological Society of America, 1966; 7: 50.
- Gbakima AA, Terry BC, Kanja F et al. High prevalence of bedbugs Cimex hemipterus and Cimex lectularius in camps for internally displaced persons in Freetown, Sierra Leone: a pilot humanitarian investigation. West Afr J Med 2002; 21: 268–71.
- Delaunay P, Blanc V, Del Giudice P et al. Bed bugs and infectious diseases. Clin Infect Dis 2011; 52: 200–10.
- Thomas I, Kihiczak GG, Swartz RA. Bedbug bites: a review. Int J Dermatol 2004; 43: 430–3.
- Goddard J, deShazo R. Bedbugs (Cimex lectularius) and clinical consequences of their bites. JAMA 2009; 301: 1358–66.
- Valenzuela JG, Ribeiro JM. Purification and cloning of the salivary nitrophorin from the hemipteran Cimex lectularius . J Exp Biol 1998; 201: 2659–64.
- Valenzuela JG, Guimaraes JA, Ribeiro JM. A novel inhibitor of factor X activation from the salivary glands of the bed bug Cimex lectularius . Exp Parasitol 1996; 83: 184–90.
- Goddard J, de Shazo R. Multiple feeding by the common bedbug, Cimex lectularius, without sensitization. Midsouth Entomol 2009; 2: 90–2.
- Singh S, Mann BK. Insect bite reactions. Indian J Dermatol Venereol Leprol 2013; 79: 151–64.
- Leverkus M, Jochim RC, Schad S et al. Bullous allergic hypersensitivity to bedbug bites mediated by IgE against salivary nitrophorin. J Invest Dermatol 2006; 126: 91–6.
- Pritchard MJ, Hwang SW. Cases: severe anemia from bedbugs. CMAJ 2009; 181: 287–8.
- Quach KA, Zaenglein AL. The eyelid sign: a clue to bed bug bites. Pediatr Dermatol 2014; 31: 353–5.
- Ter Poorten MC, Prose NS. The return of the common bedbug. Pediatr Dermatol 2005; 22: 183–7.
- Scarupa MD, Economides A. Bedbug bites masquerading as urticaria. J Allergy Clin Immunol 2006; 117: 1508–9.
- Hernandez RG, Cohen BA. Insect bite-induced hypersensitivity and the SCRATCH principles: A new approach to papular urticaria. Pediatrics 2006; 118: e189–96.
- Fallen RS, Gooderham M. Bedbugs: an update on recognition and management. Skin Therapy Lett 2011; 16: 5–7.
