@article {95221, title = {Pediculosis and Scabies: A Treatment Update}, journal = {American Family Physician}, volume = {86}, year = {2012}, month = {09-2012}, pages = {535-541}, abstract = {

Pediculosis\  and\  scabies\  are\  caused\  by\  ectoparasites.\  Pruritus\  is\  the\  most\  common\  presenting\  symptom.\  Head\  and\  pubic lice infestations are diagnosed by visualization of live lice. Finding nits (louse egg shells) alone indicates a his-torical\  infestation.\  A\  \“no\  nit\”\  policy\  for\  schools\  and\  day\  care\  centers\  no\  longer\  is\  recommended\  because\  nits\  can\  persist after successful treatment with no risk of transmission. First-line pharmacologic treatment of pediculosis is permethrin 1\% lotion or shampoo. Multiple novel treatments have shown limited evidence of effectiveness superior to permethrin. Wet combing is an effective nonpharmacologic treatment option. Finding pubic lice should prompt an evaluation for other sexually transmitted infections. Body lice infestation should be suspected when a patient with poor hygiene presents with pruritus. Washing affected clothing and bedding is essential if lice infestation is found, but no other environmental decontamination is necessary. Scabies in adults is recognized as a pruritic, papular rash with\  excoriations\  in\  a\  typical\  distribution\  pattern.\  In\  infants,\  children,\  and\  immunocompromised\  adults,\  the\  rash\  also can be vesicular, pustular, or nodular. First-line treatment of scabies is topical permethrin 5\% cream. Clothing and\  bedding\  of\  persons\  with\  scabies\  should\  be\  washed\  in\  hot\  water\  and\  dried\  in\  a\  hot\  dryer.

An updated version by the same authors title- Lice and Scabies: Treatment Update can be found in http://phthiraptera.info/node/95220

}, url = {https://www.aafp.org/afp/2012/0915/p535.html}, author = {Karen Gunning and Karly Pippitt and Bernadette Kiraly and Morgan Sayler} } @article {95220, title = {Lice and Scabies: Treatment Update}, journal = {American Family Physician}, volume = {99}, year = {2019}, month = {05-2019}, pages = {635-642}, abstract = {

Pediculosis\  and\  scabies\  are\  caused\  by\  ectoparasites.\  Pruritus\  is\  the\  most\  common\  presenting\  symp-tom.\  Head\  and\  pubic\  lice\  infestations\  are\  diagnosed\  with\  visualization\  of\  live\  lice.\  Nits\  (lice\  eggs\  or\  egg\  casings)\  alone\  are\  not\  sufficient\  to\  diagnose\  a\  current\  infestation.\  A\  \“no-nit\”\  policy\  for\  return\  to\  school\  is\  not\  recommended\  because\  nits\  can\  remain\  even\  after\  successful\  treatment.\  First-line\  pharmacologic\  treatment\  for\  pediculosis\  is\  permethrin\  1\%\  lotion\  or\  shampoo.\  Newer\  treatments\  are\  available but costly, and resistance patterns are generally unknown. Noninsecticidal agents, including dimethicone\  and\  isopropyl\  myristate,\  show\  promise\  in\  the\  treatment\  of\  pediculosis.\  Extensive\  envi-ronmental decontamination is not necessary after pediculosis is diagnosed. In adults, the presence of pubic lice should prompt an evaluation for sexually transmitted infections. Body lice infestation should be suspected in patients with pruritus who live in crowded conditions or have poor hygiene. Scabies in adults presents as a pruritic, papular rash in a typical distribution pattern. In infants, the rash can also be vesicular, pustular, or nodular. First-line treatment for scabies is permethrin 5\% cream. Clothing and bedding\  of\  persons\  with\  scabies\  should\  be\  washed\  in\  hot\  water\  and\  dried\  in\  a\  hot\  dryer.\  Counseling\  regarding appropriate diagnosis and correct use of effective therapies is key to reducing the burden of lice and scabies.

A related handout written for patients is attached 95220 patient handout.pdf

article (Letters to the Editor see http://phthiraptera.info/node/95321)

A previous version by the same authors published in 2012 title: Pediculosis and Scabies: A Treatment Update can be found in http://phthiraptera.info/node/95221


Response to the article (Letters to the Editor see http://phthiraptera.info/node/95321)

}, url = {https://www.aafp.org/afp/2019/0515/p635.html}, author = {Karen Gunning and Bernadette Kiraly and Karly Pippitt} }