Lifestyle Recommendations for Management of Pediculosis from the Viewpoint of Persian Medicine

Introduction: Pediculosis Capitis (head lice infestation) is the most common disease of the bloodsucking insect which affects approximately six to twenty million cases and results considerable economic burden annually. In this study we aim to investigate some medieval Persian views on the role of non-pharmacological treatment strategies for prevention and control of pediculosis and compare their prescriptions with current findings. Materials and methods: In this qualitative study, we reviewed some well-known Persian medicine (PM) textbooks based on the selected keywords (Shepesh, Reshk, Ghamal and Seyban) to collect the viewpoint of PM scholars for pediculosis and its treatments. Also, we searched in the databases such as PubMed, Science direct and Scopus about the topic. Results: Persian medicine scientists believed that there are six essential health principles (SetteZaroorieh), which can affect human health and prevent diseases including air, nutrition, exercise, sleep and wakefulness, exertion of unnecessary materials from the body and finally psychological concepts. Proper management of these essential factors can improve lifestyle of people affected with pediculosis and also play a key role in prevention of head lice infestation. Conclusion: There are several suitable recommendations for prevention and control of pediculosis according to essential health principles in PM which can consider beside current drug treatments and the individual health recommendations for complete control of the disease

Serie parasitosis en dermatología: pediculosis / Parasitosis in dermatology: pediculosis

La enfermedad producida por Pediculus humanus capitis, conocida como pediculosis, es una parasitosis específica del ser humano de distribución mundial. El contagio puede ser directo por contacto con el cuero cabelludo de una persona afectada, o por fómites contaminados con parásitos, por lo que no distingue raza, sexo, edad ni nivel socioeconómico. Presentamos el caso de una paciente de 80 años con una forma típica de pediculosis. (AU)

The disease caused by Pediculus humanus capitis, known as pediculosis, is a human specific parasitosis. It has a worldwide distribution. Transmission can be by direct contact with the scalp of an affected person or by contaminated fomites with parasites. This infestation makes no distinction of race, sex, age, or socioeconomic status. We present a case of an 80 years old patient with a typical case of pediculosis. (AU)

Pediculosis hasta 2008 / Pediculosis until 2008

La pediculosis es una patología cuya prevalencia está en aumento en todo el mundo. En parte, esto se debe a las dificultades que presentan los tratamientos disponibles. Los pediculicidas químicos usados actualmente son piretrinas (permetrina 1% es la más usada), malatión 0,5%, lindano 1% (cuestionado debido a su neurotoxicidad e impacto ambiental) e ivermectina (sin aprobación de la Food and Drug Administration). Si bien existe una creciente evidencia sobre el desarrollo de resistencia a estos pediculicidas, es importante considerar la correcta realización de los tratamientos o la presencia de una reinfección antes que el desarrollo de resistencia propiamente dicho, razón por la cual es recomendable que el problema sea abordado en forma conjunta por el equipo de salud, la escuela y la familia. Actualmente se investigan nuevas opciones terapéuticas más seguras y eficaces como, por ejemplo, métodos físicos, aceites esenciales y derivados vegetales, nuevos insecticidas o la incorporación formal de opciones como la ivermectina, para lo cual aún se requiere más investigación que aporte evidencia de mejor calidad metodológica.

Head lice is a condition whose prevalence is increasing worldwide, probably because of the difficulties that available treatments present. Chemicals pediculicides currently in use are pyrethrins (1% permethrin is the most widely used), 0.5% malathion, 1% lindane (questioned because of its neurotoxic effects and their environmental impact) and ivermectin (not yet approved by the Food and Drug Administration). While there is increasing evidence of growing development of resistance to these pediculicides, it is important to consider the proper conduct of the treatments or the presence of reinfection before considering the real development of resistance, for these reasons a global assessment that includes the health equipe, the school and the family is desirable. New therapeutic options, both safe and effective, are being investigated. They include physical methods, products derived from essential oils and herbal products, new insecticides and ivermectin, which requires further research to provide evidence of better quality.

Eficacia comparativa de esquemas terapéuticos con cotrimoxazol, en pediculosis capitis / Comparative efficacy of cotrimoxazol treatments in pediculosis capitis

Objetivo: Evaluar la eficacia de dos esquemas de tratamiento con cotrimoxazol para la pediculosis capitis. Diseño: Estudio prospectivo, longitudinal, experimental y comparativo. Lugar: Hospital Regional Docente de Trujillo. Participantes: Niños con pediculosis capitis. Intervenciones: Se estudió dos grupos de pacientes, de 36 y 38 niños respectivamente, entre 6 y 12 años de edad, a quienes se administró cotrimoxazol 400/80 mg (tabletas) dos veces por día: El primer grupo recibió dos cursos semanales de tres días del fármaco y el segundo un curso continuo de diez días. A las dos semanas de finalizado el tratamiento; se evaluó nuevamente a los niños. Se utilizó la prueba Z para la diferencia de proporciones. Principales medidas de resultados: Eficacia comparativa deltratamiento con cotrimoxazol. Resultados: El tratamiento fue eficaz en 80,5% de pacientes del grupo 1 y en 78,9% del grupo 2. No se encontró diferencia significativa entre ambos esquemas (p > 0,05). Conclusiones: Cotrimoxazol, en 2 cursos semanales de 3 días y en un curso continuo de 10 días, tiene eficacia similar en el tratamiento de pediculosis capitis en niños.

Objective: To compare two cotrimoxazol protocols efficacy for the treatment of head lice in children. Design: Prospective, longitudinal, experimental and comparative study. Setting: Trujillo Regional Teaching Hospital. Participants: Children with pediculosis capitis. Interventions: Seventy four 6 to 12 year-old patients were enrolledin two groups. Patients belonging to group 1 (36) were treated withcotrimoxazol 400/80 mg for three days for two courses and those in group 2 (38) with cotrimoxazol 400/80 mg daily for ten days. They were evaluated after two weeks. We used the Z test for proportion differences. Results: The efficacy was 80,5% and 78,9% for groups 1 and 2 respectively and there was no significant difference in thetwo groups treatment results. Conclusions: Cotrimoxazol given intwo 3-day weekly courses and in one 10-day continuous course had similar efficacy in childrenÆs pediculosis capitis treatment.

Crab louse infestation of eyelashes

To present clinical features and management of ten patients of crab louse infestation of eyelashes Present study includes ten cases of crab louse infestation of eyelashes seen during last few years in eye OPD of Services Hospital and Jinnah Hospital Lahore. Patients visiting eye out-patients department who were reported to have crab louse infestation of eyelashes were examined in detail including systemic examination. Infested parts of the body were photographed as well. The adult patients were asked about similar problem in their sexual partners and the parents of children were inquired similarly. All patients were treated with adequate washing of eyelashes and other involved parts with soap and water and application of any ophthalmic preparation having petroleum base e.g. Polyfax eye ointment in the conjunctival sac and eyelashes and anti-lice dermal preparation e.g. Lotrix [Permethrin] skin preparation to other parts. All patients were followed for a period of three months performing examination of eyelashes with slitlamp and systemic examination every two weeks. Seven out of ten patien ts were adults [70%], five males and two females, and remaining three patients were children [30%]. Forty percent of patients [4/10 patients] had related systemic lesions, including blue gray macules [Maculae caeruleae] and the bullous lesions. In addition to systemic dermatological manifestations, ocular symptoms included deposits in the roots of eyelashes, irritation or feeling of some thing moving in lid margins, mild lacrimation and redness. Ocular examination revealed multiple lice anchoring themselves in the roots of eyelashes sucking blood, along with hundreds of nits cemented with eyelashes. There was a mild conjunctival congestion. Removal of lice resulted in formation of small ulcers of margin of lid. Adequate washing with soap and water, followed by application of Polyfax eye ointment for two to three weeks, resulted in complete cure of the palpebral disease. This study emphasizes the significance of an infrequently seen clinical condition of crab louse infestation of eyelashes, not only as a venereal disease expecting much higher number of infections but also as an important cause of refractory cases of chronic irritation of eyes with blepharitis. Careful examination of eyelids with slitlamp microscope may establish the diagnosis. All the sexual partners should be treated simultaneously. Other parts of the body having less dense population of hair should be examined and adequate measures should be taken for the management, including application of anti-lice dermal ointment e.g. Lotrix [Permethrin] skin ointment

Pediculosis in primary schools

Pediculosis is common in primary schools in overcrowded sectors, in one study [10-12°%] of children have pediculosis. Pediculosis causing itching and enlargement of occipital postauricular lymph nodes and transmitted Rickettseal disease [Typhus fever] which remain unnoticed of

Mechanical Treatment of Phthiriasis Palpebrarum

Phthiriasis palpebrarum is a rare disease in which crab lice infest the eyelashes. It can cause pruritic lid margins or unusual blepharoconjunctivitis and is difficult to diagnose and treat. We diagnosed and managed a case of phthiriasis palpebrarum in both upper eyelids, accompanied by nits, on the scalp of a 6 year-old female child. We removed the eyelashes, including lice and nits, by pulling with fine forceps without sedation. On the second month after treatment, all lice and nits were eradicated without recurrence and the eyelashes grew back. In conclusion, phthiriasis palpebrarum can be diagnosed by close examination of the eyelashes and eyelid margins with slit lamp and can be managed mechanically.

Estudo comparativo da eficiência de três diferentes pentes finos na retirada de piolhos e lêndeas / Comparative study on the efficienty of three different fine-tooth combs to remove lice and nits

No presente estudo foram avaliados três pentes finos para retirada de piolhos e lêndeas, em indivíduos comdiagnóstico de pediculose capitus (Pediculus humanus capitis). Foram selecionadas 30 crianças com idade entre 2 e 12 anos. O objetivo foi avaliar a eficácia dos três pentes finos na retirada de piolhos e lêndeas,sendo: pente 1, incluíndo na embalagem do produto Toppyc, pente 2 incluíndo na embalagem do produto à base de permetrina a 1 porcento, fabricado pelo Laboratório Sintofarma S/A. Os resultados obtidos mostram que näo há diferença estatística significante entre os números médios de piolhos retirados pelos três pentes. Em relaçäo às lêndeas, é notável a média do pente 1 que se apresenta cinco vezes superior à do pente 2 e 15 vezes superior à do pente 3 (au)

Phthiriasis palpebral / Phthiriasis of the eye-lid

La phthiriasis palpebral es una causa poco común de blefaritis y conjuntivitis que puede fácilmente ser omitida por el oftalmólogo. Un alto índice de sospecha y un cuidadoso examen en la lámpara de hendidura sobre las pestañas y márgenes palpebrales del paciente lleva a un diagnóstico certero. Aunque los piojos pueden ser difíciles de detectar, la acumulación de liendres (larvas del piojo) y de las heces de los piojos sobre las pestañas, que se aprecian como un material granular rojizo marrón en la base de las pestañas, ayuda a realizar el diagnóstico. La pediculosis se transmite por contacto íntimo con individuo infestado por vestidos y ropas de cama contaminadas, la otra forma de transmisión es típicamente por contacto sexual. En los niños la infestación puede ser debida al contacto íntimo con la madre o niñera. Pestañas y cejas son los sitios de predilección. En los adultos la phthiriasis palpebral es probablemente transmitida del área genital a los ojos mediante la mano. El tratamiento medicamentoso debe acompañarse de una cuidadosa remoción de los piojos y liendres de las pestañas del paciente. La aplicación local de pediculicidas tales como: fluoresceína al 20 por ciento, ungüento de óxido de mercurio amarillo al 1 por ciento, petrolato de fisostigmina, lociones de hexacloruro de gamma benceno, malatión, carbaryl y permetrina, o el uso de crioterapia y láser de argón. Miembros familiares, contactos sexuales, compañeros íntimos deben ser examinados y tratados, vestidos, ropas artículos personales deberán ser desinfectados a una temperatura de 50 grados centígrados por 30 minutos.

Efectividad de lociones capilares sobre poblaciones de Pediculus capitis resistentes a insecticidas / Effectiveness of capilar lotions against insecticide resistant Pediculus capitis populations

Se estudio la influencia de los distintos componentes en la efectividad de lociones experimentales sobre piojos resistentes a insecticidas piretroides. Se encontró que el aumento de la concentración del insecticida D-fenotrina desde 0,2 por ciento (concentración recomendada en lociones comerciales) hasta 0,5 por ciento, no produjo diferencias significativas (p=0,495) en la actividad pediculicida. Por el contrario se encontró un aumento significativo de efectividad de lociones experimentales con d-fenotrina o,2 por ciento al agregar alcohol alifático dodecanol en concentración 10 por ciento. El volteo de piojos expuestos se incrementó desde 23,+- 4,7 por ciento hasta 92,0+- 7,5 por ciento respectivamente. Se encontró además que las lociones conteniendo sólo dodecanol (sin d-fenotrina) producian un volteo significativo de los piojos expuestos (35+-8,5). Se comprobó que el volteo producido por la loción con dodecanol mostraba recuperación parcial a las 18 horas, mientras que la efectividad de las lociones que combinan dodecanol con insecticidas aumentaba al cabo de 18 horas alcanzando 100 por ciento de mortalidad. Se postula que la potenciación de actividad pediculicida demostrada para lociones que combinan dodecanol y d-fenotrina podría deberse a daño cuticular producido por el alcohol que favorecería la penetración del insecticida para ejercer su efecto tóxico

Experiencia de atencao de enfermagem no controle da pediculose num macro hospital psiquiatrico estatal, durante 10 anos / Experience of nursing assistance in the pediculous control in a state psychiatric hospital, during a period of 10 years

Relato historico dos 10 anos (1981-1991) de experiencia de atencao de enfermagem no controle de pediculose num macro hospital psiquiatrico estatal. Os dados foram obtidos a partir dos relatorios mensais e anuais da Comissao de Pediculose. A atuacao efetiva da Comissao neste periodo, com levantamentos de necessidades e dificuldades periodicas, reorganizacoes frequentes, novas rotinas, reformulacoes de propostas e busca de novas alternativas tecnicas, administrativas e assistenciais, justifica o alcance de seus objetivos; ou seja a atencao de enfermagem aos infestados e a diminuicao da incidencia da pediculose.