Pediculosis CapitisBy :

Andi Zuljumadi Adma

Sri Mahtufa

Riana Inggrid

Asistant :

dr. Sari Handayani

Introduction

• Pediculosis capitis or commonly known as head lice is an infection of the skin and scalp hair caused by Pediculus humanus variant capitis.

Pediculus Humanus Variant Capitis Nits

Epidemiology of Head Lice

Pediculosis capitis

Age

Gender

Sosio-economic

Hair characteristic

Worldwide problem

Etiopatogenesis3 Species Of Body Lice

Pediculosis Capitis

Pediculosis Humanus

Phitirus Pubis

Colour Gray and white Greyish white Transculent

Size 2 to 4 mm flatFemale has larger than male

4 to 5 mm 0.8 to 1.2 mm length

Body Parts •Six-legged•Two eyes•Wingless

•Six-legged•Two eyes•Wingless

•Six-legged with four legs resembling crab claws•Two eyes•Wingless

Head Lice Body Lice

Pubic Lice

Lice Life Cycle

Transmition

• Direct contact :need very close head-to-head

contact to spread from one person to another.

• Indirect contact : such as common household appliances or personal belongings. (towels,combs, brushes for hair polish, or hats)

Clinical Manifestation

Infestation of Pediculosis capitis Pruritus ( Most common complain) Scratching marks Erythema Lichenification Posterior cervical lymphadenopathy Excoriated Lice dirt on scalp Secondary impetigo

Diagnose

• Observation of nits, live nymphs or adult lice.

• Use fine-tooth comb and magnifying glass.

Supporting Examination

• Laboratory tests :

– Microscopy of lice or nits on the hair is in check to confirm macroscopically examination of the skin head and hair.

Differential diagnose:

Tinea capitis gray patch ring

worm that caused by microsporum

genus

Dermatitis seborrhoic erytema &

oily scale, diffuse

Tambah lagi DDnya

White PiedraCaused by

Trichosporon beigelii

Nodul on the hair shaft,

broken hair

Black Piedra

caused by Piedraia hortae

Nodul out the hair.

Treatment • Non-medicamentosa :

Use comb to eliminate nymphs that hatch between

treatments pediculicidal.

keep the surrounding environment clean

Oral treatment

Name of drug Mechanism DoseIvermectin an anti worm.This leads to hyperpolarization,

causing flaccid paralysis culminating in the death of the parasite.

200 mg / kg

Albendazole A antiparasitic blockade mitochondrial function, ultimately leading to ATP depletion and cell death

400 mg as a single dose or repeated more than 3 days

levamisole a nicotinic acetylcholine receptor agonist, which interfere with carbohydrate metabolism of the parasite.

Used at a dose of 3.5 mg / kg administered for 10 hari.12

Topical treatmentAgent Mechanism of

actionMethod of use form

Permethrin (1%)(Scabimite cream 5%)

Disrupts the sodium channel current leading to delayed depolarization

Topical application on clean and dry hair for 10 minutes

cream

malathion (0,5%)(Ovide®)

Acetyl cholinesterase inhibitor- respiratory depolarization

before bedtime, wash hair and then use malathion. Wash the hair in the morning. Repeat for a week

lotion

Lindane 1% (Gamma benzene hexachloride, peditox)

CNS toxicity applied, then leave for 12 hours, then washed and combed

cream

Carbaryl (0,5%)Sevin

Acetyl cholinesterase inhibitor – respiratory paralysis

Topical aplication for 8-12 hours

spray

Benzyl Alcohol Kills head lice by asphyxiation

Topically for 10 minutes

Pyrethrin 1% wash hair with shampoo and then use permetrin cream and leave about 10 minutes, then whased

cream

Complication

• Secondary bacterial infection may worsen enough to make child fever and lethargy

Prognosis

• This infection is basically harmless. However, the stigma associated with head lice and psychological trauma experienced by some people in their efforts to eliminate the infection are very excessive.

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