- Incidence And Epidemiology
It mainly affects the poor and neglect and flourishes in overcrowded, dirty situations where individuals seldom change their clothes. There is great variation in the number of eggs and lice on the clothing. In most cases the number of lice is small but in some thousand of lice may be present. Transmission is mainly by direct close body contact or by sharing infested clothing. Lice on a cooling dead body will look for alternate lodgings, and doctors asked to certify death in a vagrant should be aware of this.
- Clinical Features
- Intense pruritus is the chief complaint. It is due to sensitization to salivary antigens of the lice.
- Excoriation with secondary bacterial infection and hyperpigmented changes are common physical findings.
- When the lice are not feeding, they stay in the clothing.
- Therefore, it is important to examine the inner lining of clothing including the seams of underpants.
- Hands and feet are usually not involved and there is a predilection for the upper back.
- The characteristic distribution helps to distinguish it from scabies.
- The principal louse-borne diseases are epidemic typhus, trench fever and louse borne relapsing fever.
It is the clothing rather than the patients which require treatment. Destruction of the lice is accomplished by laundering or boiling the clothing and bedding. The patient should bath thoroughly with soap and water.
|Diseases causing: mild or no itching:
|Diseases causing: moderate itching:
|Diseases causing: severe itching: