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Therapeutic Approach

Pediculosis is an infestation of humans by lice that most commonly spreads through direct contact. There are 3 species of lice that infest humans: pediculus humanus capitis (head louse), pediculus humanus humanus (body louse), or phthirus pubus (crab louse). Clinical presentation includes an onset of pruritus, excoriations, erythema and scaling around mite bites however some individuals may remain asymptomatic after infestation. Diagnosis is confirmed with identification of egg capsules (nits) via dermatoscopy, and treatment is often approached based on the following factors: local resistance patterns, distribution, individual patient characteristics, and access to a physician for prescription treatments.1 Although some physical treatment methods are available (shaving one’s head or combing nits out after application of moisturizer like Cetaphil to hair), a combination of a topical and oral pediculicide is the most effective.2 To decrease potential for reinfestation, it is advised to repeat treatment(s) after 1 week and thoroughly clean all clothing, hats, pillowcases, towels as well as bedding used the week before. See Table 151-1.

Table 151-1Pediculosis Treatment Table

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