Post on 08-Nov-2014
description
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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