DERM 04 and 05: Body Lice

Question 1

Describe the method of transmission of body lice infestations.

Answer 1

• requires direct physical contact (sign of poor hygiene or crowded conditions)
• contact with infested clothing, bedding, etc.
• may transmit other organisms: epidemic typhus (caused by Rickettsia prowazekii), trench fever (caused by Bartonella quintana), relapsing fever (caused by Borrelia recurrentis)

Question 2

What are the signs and symptoms of body lice infestations?

Answer 2

• live in seams of clothing and come on to body to feed
• pruritus and skin reactions (red marks, parallel linear excoriations)
• usually in flanks, axillae, and around waist and neck

Question 3

What are the detection methods for body lice infestations?

Answer 3

visual detection – lice is found on clothing (especially at seams)

Question 4

What are the non-pharmacological treatments for body lice infestations?

Answer 4

• improve hygiene: counsel on washing entire body and putting on clean clothes, consider patient-specific and socioeconomic challenges
• clean: wash in hot water and use hot dryer or store in sealed plastic bag for 14 days, dry clean, steam iron seams of clothing

Question 5

What is the pharmacological treatment for body lice infestations?

Answer 5

NOT required

• consider anti-pruritic treatments (topical corticosteroids, 1st gen oral antihistamines) to control symptoms – NOT curative
• may use drug treatment (ivermectin) if severe