PEDICULOSIS

INTRODUCTION
Infectious disease results from the interplay between those few pathogens and the defenses of the hosts they infect. Pediculosis is one of the infection diseases which commonly effected on women and child. This disease caused by the host, louse infestation which live on the body.

Pediculosis is an infestation of lice. Humans can be infested with three kinds of lice: Pediculus capitis (head lice), Pediculus corporis (body lice), and Phthirus pubis (pubic, or crab, lice). Lice feed on human blood and deposit their eggs (nits) on the hair shafts (head lice and pubic lice) and along the seams of clothing (body lice).

ETIOLOGY
1. PEDICULOSIS, INFESTATION BY LICE, INVOLVE 3 DIFFERENT PARASITES : PEDICULOSIS HUMANUS CAPITIS (HEAD LOUSE/LICE) PEDICULOSIS HUMANUS CORPORIS (BODY LOUSE/LICE) PHTHIRUS PUBIS (PUBIC @ CRAB LOUSE)

HEAD LICE
Infest people of all ages but commonly on preschool & children. Head lice are not a sign of poor hygiene because all socioeconomic groups are infected. Adapted to life on human hair and the scalp. Less commonly lice can also be found on eyes brows and eye lashes.

BODY LICE
Generally found only in human populations with extremely poor hygiene. Body lice hide in the seams of clothing, getting on the infested persons skin to feed only at intervals. Generally in areas of the body where clothing is in close proximity to the body. Example : waist, arm pits, thighs and groin.

CRAB LICE
Pubic lice resemble small crabs which live in the ocean. Hence the term crab are frequently refer to an infestation. All age groups can be infested but more prevalent in sexually active adults. Itching of the genital area is a common symptom. Crab lice are usually found at coarsely haired parts such as axilla & genital parts (man & woman).

ADDICTION INFO
The disease is frequently seen in children. Girls are affected more than boys. Lice most often spread by close @ sexual contact. Lice feed on human blood every 3-6 hours. Female lay eggs known as nits that hatch every 10 days. Lice require human blood to survive, so it buries its head inside the skin and excretes substance into the skin that causes itching.

PATHOPHYSIOLOGY
The PEDICULOSIS & PHTHIRUS organisms look similar & interbreed freely. Both types lay eggs on the hair shafts & remain firmly adherent, resisting both mechanical and chemical removal. Pediculosis moves well & easily passed to another person. Conversely, phthirius are slow moving & cannot be passed unless cilia is brought into close proximity with infested cilia. Both are associated with crowded conditions & poor personal hygiene.

CLINICAL MANIFESTATION
P. capitis
Symptoms that may appear are itchiness of the neck, scalp and ears, pruritis, as well as puss in affected areas (bites)

P. corporis

P. pubis

Itchiness and visible Itchiness in pubic bite marks on the body areas and armpits and pruritis, especially around the waist and armpits. There may also be crusting and redness due to secondary bacterial infections

DIAGNOSTIC TEST
P. capitis
Identification of louse and nits. This can be aided with the use of a fluorescent Underwood light. Careful and thorough combing can also be done to search for nits and lice

P. corporis
Identification of louse or nits on clothing. The adult louse may hard to identify because they move quickly across the body and clothes.

P. pubis
Identification of louse or nits in the pubic and armpit areas. Identification of the adult may be difficult because of its translucense

NURSING DIAGNOSE

potential impaired skin integrity related to insect bites, scratching.

Medical Treatment
Over-the-counter medications Prescription medications

Over-the-counter medication
Pyrethrins combine with piperonyl butoxide : 1) Brand name products: A-200*, Pronto*, R&C*, Rid*, Triple X*. 2) Naturally occurring pyrethroid extracts from the chrysanthemum flower. 3) Safe and effective when used as directed. 4) Should not be used by persons who are allergic to chrysanthemums or ragweed. 5) Use on children 2 years of age and older.

 Permethrin lotion 1% 1) Brand name product: Nix*. 2) Synthetic pyrethroid similar to naturally occurring pyrethrins. 3) Safe and effective when used as directed. 4) Kill newly hatched lice for several days after treatment. 5) Use on children 2 months of age and older.

Prescription Medications
Malathion lotion 0.5% 1) Brand name product: Ovide*. 2) Is an organophosphate. 3) Safe and effective when used as directed. 4) Pediculicidal (kills live lice) and partially ovicidal (kills some lice eggs). 5) Use on persons 6 years of age and older. 6) Can be irritating to the skin and scalp, contact with the eyes should be avoided. 7) Flammable : do not smoke or use electrical heat sources, including hair dryers, curlers, and curling or flat irons, when applying malathion lotion and while the hair is wet.

 Benzyl alcohol lotion (5%) 1) Brand name product: Ulesfia lotion*. 2) Is an aromatic alcohol and a white topical lotion . 3) Use on persons who are 6 months of age and older. 4) Can be irritating to the skin and eyes, contact with the eyes should be avoided.

 Lindane shampoo 1% 1) Is an organochloride. 2) Not recommended as a first-line therapy. 3) Overuse, misuse, or accidentally swallowing lindane can be toxic to the brain and other parts of the nervous system. 4) Should not be used to treat premature infants, persons with HIV, a seizure disorder, women who are pregnant or breast-feeding, persons who have very irritated skin or sores where the lindane will be applied, infants, children, the elderly, and persons who weigh less than 110 pounds.

Stress importance of second application of pediculicide or shampoo.

Contact community agencies for suggestions for reducing epidemics

Dont use hair dryer

NURSING INTERVENTION

Use plastic drape to prevent drug getting on other body parts.

Apply, or teach family to apply, pediculicide shampoo or rinse.

NURSING DIOGNOSES

Body image disturbance related to infestation

NURSING INTERVENTION
Caution children against sharing combs, hats, caps, scarves, coats, or other items used on or near the hair. Treat family member with evidence of infestation Explain or reinforce explanation of the condition and its mode of transmission. Allay childs feelings of shame and embarrassment Reassure family that anyone can get pediculosis with no association with age, cleanliness, and socioeconomic level.

CONCLUSION AND DISCUSSION

Pediculosis are ubiquitous, contagious, and debilitating parasitic dermatoses. They have been known since antiquity and are distributed worldwide. Specific forms of pediculosis, including bullous scabies or localised crusted scabies, may be misdiagnosed. Definitive parasitic diagnosis can be difficult to obtain, and the value of new techniques remains to be confirmed. Difficulties in management have returned scabies and pediculosis to the limelight.

 Physicians also should take an active role in the treatment of this infestations by being available to confirm active cases and being knowledgeable about first- and second-line treatment options in their communities.

 Pediculosis is a major health problem in many parts of the world including both developed and underdeveloped countries. Pediculosis is the most prevalent condition in schooland preschool-aged groups and faced by the girls more than the boys. This infestation is associated with substandard hygienic practices, living with more than five people at home, the length of hair and socioeconomic and cultural condition. The study shows that poor countries recorded high rates of pediculosis disease. It can disturb the normal daily life and can cause disturbance of normal growth.

 It can easily be prevented with simple steps such as practicing good hygiene improvements in socioeconomic and cultural status. A lower prevalence can be achieved through health education programs for students and parents, particularly with regard to the importance of early detection and effective management strategies. These measures, along with curing infected students and possible cases within the family, will decrease the rate of infestation and lead to greatly improved control.

REFERENCES
http://medicalstudy.blogspot.com/2011/10/pedicul osis-phthiriasis.html Hargrove-Huttel, Ray A. Medical- Surgical nursing.4th ed. /Ray A. Hargrove-Huttel http://www.drugswell.com/wow/index.php http://www.rightdiagnosis.com/artic/body_lice_dp d.htm http://emedicine.medscape.com/article/225013overview