July/August 2012
EDITORIAL
Combing the hair regularly, using a fine-tooth comb, with subsequent inspection, to detect dead nits from live ones (grey and white, respectively) has proved a useful alternative to the forenamed medications and has none of the associated side effects sometimes seen with medication use. All material that has had head contact, eg, pillows, headscarves, should be washed at 130°F for 30 minutes or tightly contained in a plastic bag for 2 weeks.18 Other fomites, such as headphones or combs should also be cleansed with isopropyl alcohol.8 Opinion is divided on whether floors at home or in schools should be cleaned, with a recent Australian study showing no benefit after vacuuming a known infested room.19 Prophylaxis, by educating parents, teachers, school nurses, and assistants at daycare facilities is essential. CONCLUSIONS
4
Feldmeier H, Heukelbach J. Epidermal parasitic skin diseases: a neglected category of poverty-associated plagues. 2008. http://www.who.int/bulletin/volumes/87/2/07-047308/en/. Accessed April 23, 2012.
5
Head lice. Patient.co.uk Web site. http://www.patient.co.uk/ doctor/Head-Lice.htm. Accessed April 23, 2012.
6
Head lice infestations: a clinical update. Paediatr Child Health. 2008;13;692–696.
7
Amr ZS, Nusier MK. Pediculosis capitis in northern Jordan. Int J Dermatol. 2000;39:919–921.
8
Nutanson I, Steen CJ, Schwartz RA, et al. Pediculus humanus capitis: an update. Acta Derm-Venereol. 2008;17;147–159.
9
Juranek DD, Jessup CA, Coll B. Pediculosis: The Philadelphia School Problem. In: Parish LC, Nutting WB, Schwartzman RM. Cutaneous Infestations of Man and Animal. New York, NY: Praeger; 1983:151–163.
10 Downs AM, Stafford KA, Stewart GH, et al. Factors that may be influencing the prevalence of head lice in British school children. Pediatric Dermatol. 2000;17:72–74.
Head lice and their escapades remain a concern, being nondiscriminatory and affecting everyone from all ages, classes, ethnicities, nationalities, and sexes. It is a worldwide problem costing some countries millions of dollars. Pediculosis capitis infestations are not pleasant clinically, due to the itching and secondary pyoderma and, in part, to the hysteria produced by the thought of the infestations. Head lice, unlike body louse, have never been implicated in causing disease. As unpleasant as the head louse is, it, like other arthropods, has been around for longer than homosapiens and will likely be here forever.
11 Frankowski BL, Weiner LB. Head lice. Clinical report. Pediatrics. 2002;110:638–643.
REFERENCES
16 Burgess IF, Brown CM, Lee PN. Treatment of head louse infestation with 4% dimeticone lotion: randomised controlled equivalence trial. BMJ. 2005; doi:10.1136/bmj.38497.506481.8F.
1
Graham-Brown R, Burns T. Lecture notes. Dermatology. 9th ed. Malden, MA: Blackwell Publishing; 2007:45.
2
Burns DA. Diseases caused by arthropods and other noxious animals. In: Burns T, Breathnach S, Cox N, Griffiths C, eds. Rook’s Textbook of Dermatology. Oxford, England: WileyBlackwell; 2010;33.16–33.21
3
Pilger D, Heukelbach J, Khakban A, et al. Household-wide ivermectin treatment for head lice in an impoverished community: randomized observer-blinded controlled trial. 2009. http://www. who.int/bulletin/volumes/88/2/08-051656/en/. Accessed April 23, 2012.
12 Witkowski JA, Parish LC. What’s new in the management of lice. Infect Med. 1997;14;287–288. 13 Buxton PA. The louse. an account of the lice which infest man, their medical importance and control. In: The Biology of Pediculus Humanus. 2nd ed. London: Edward Arnold; 1947:71–73. 14 Leo NP, Campbell NJ, Yang X, et al. Evidence from mitochondrial DNA that head lice and body lice of humans (Phthiraptera: Pediculidae) are conspecific. J Med Entomol. 2002;39:662–666. 15 Pearlman DL. a simple treatment for head lice: dry-on, suffocationbased pediculicide. Pediatrics. 2004;114:e275–e279.
17 Chosidow O, Giraudeau B, Cottrell J, et al. Oral ivermectin versus malathion lotion for difficult-to-treat head lice. New Engl J Med. 2010;362:896–905. 18 Food and Drug Administration. Consumer Health Information. 2009. http://www.fda.gov/downloads/ForConsumers/ConsumerUpdates/UCM173526.pdf. Accessed April 23, 2012. 19 Speare R, Thomas G, Cahill C, et al. Head lice are not found on floors in primary school classrooms. Austr New Zealand J Public Health. 2002;26:208–211.
VINTAGE LABEL
Courtesy of BuyEnlarge, Philadelphia, PA SKINmed. 2012;10:198–201
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Pediculosis Capitis Revisited