Pediculosis capitis grave en una niña inscrita en una guardería / Severe pediculosis capitis in a nursery school girl

La pediculosis capitis es la ectoparasitosis más frecuente a nivel mundial. La infestación es causada por Pediculus humanus capitis (piojo de la cabeza) y afecta el cabello, el cuero cabelludo y la piel. Rara vez se manifiesta con otro tipo de sintomatología y, por lo general, su curso es benigno si se trata adecuadamente. Se presenta el caso de una menor con pediculosis capitis de 18 meses de evolución, asociada con forúnculos, lesiones cutáneas, múltiples adenopatías y anemia, que no mejoró tras la aplicación del champú. Inicialmente, llamó la atención la presencia de forúnculos, alopecia y adenopatías. La persistencia de la pediculosis capitis y el rascado intenso alteraron la integridad de la epidermis y facilitaron las infecciones secundarias por bacterias patógenas y oportunistas que produjeron impétigo, forunculosis, excoriaciones, costras hemáticas, anemia, alopecia y linfadenopatías. La pediculosis capitis afectó notoriamente a la paciente al causarle problemas psicológicos y de salud, agudizados por su condición económica y social. La paciente presentó manifestaciones clínicas poco frecuentes (forunculosis, anemia, fiebre, alopecia y adenopatías), lo cual se vio facilitado por la persistencia de los factores de riesgo y el hecho de que no se le inspeccionaba la cabeza ni se removían los insectos. La educación sobre los factores de riesgo y el control sanitario es indispensable para controlar la infestación.

Pediculosis capitis is the most frequent ectoparasitosis around the world. The infestation is caused by Pediculus humanus capitis (head louse), which affects hair, scalp, and skin. It rarely presents with more symptoms and in the majority of the cases, it shows a benign course if treated properly. We present the case of a nursery school girl with head lice infestation for 18 months. She did not improve after the shampoo treatment. This case was associated with furunculosis, skin lesions, multiple adenopathies, and anemia. Initially, the presence of boils, alopecia, and lymphadenopathy was evident. The persistence of pediculosis capitis and intense scratching induced changes on skin integrity, facilitating opportunistic bacterial superinfection that led to impetiginization, furunculosis, excoriations, hematic scabs, anemia, alopecia, and lymphadenopathies. Pediculosis capitis affected the patient triggering psychological, economic, social, and other health problems. The patient presented uncommon symptoms (furunculosis, anemia, fever, alopecia, and adenopathies) resulting from the persistence of risk factors and the absence of head inspection and mechanical removal of insects. The education about the risk factors, as well as sanitary controls, are essential to contain the infestation.

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

Prevalence and Alternative Treatment of Head-Lice Infestation in Rural Thailand: A Community-Based Study

Head-lice infestation, pediculosis capitis, remains a public-health burden in many countries. The widely used first-line pediculicides and alternative treatments are often too costly for use in poor socio-economic settings. Ivermectin has been considered an alternate treatment for field practice. This study was composed of 2 parts, a cross-sectional survey and an intervention study. The main objectives were to determine the prevalence and potential factors associated with head-lice infestation, and to evaluate the effectiveness and safety of oral ivermectin administration. A community-based cross-sectional survey was conducted among 890 villagers in rural areas along Thai-Myanmar border. Females with infestations were eligible for the intervention study, and 181 participated in the intervention study. A post-treatment survey was conducted to assess acceptance of ivermectin as a treatment choice. Data analysis used descriptive statistics and a generalized-estimation-equation model adjusted for cluster effect. The study revealed the prevalence of head-lice infestation was 50% among females and only 3% among males. Age stratification showed a high prevalence among females aged <20 years, and among 50% of female school-children. The prevalence was persistent among those with a history of infestation. The major risk factors were residing in a setting with other infected cases, and sharing a hair comb. The study also confirmed that ivermectin was safe and effective for field-based practice. It was considered a preferable treatment option. In conclusion, behavior-change communication should be implemented to reduce the observed high prevalence of head-lice infestation. Ivermectin may be an alternative choice for head-lice treatment, especially in remote areas.

Epidemiological aspects of head lice in children attended to at a public hospital in Uberlândia, Minas Gerais state, Brazil

Pediculosis capitis is a public health problem not only in Brazil, but also in many countries worldwide. Children are the most likely population group to be infested. The purpose of this study was to verify the prevalence of head lice in children seen at the public hospital in Uberlândia, Minas Gerais State, and factors associated with ectoparasitosis in this group. In addition, data about the transmission, prevention and control were obtained from the children's parents or guardians. The scalp and hair of every child aged 2 to 12, attended to at the hospital pediatric outpatient clinic from 2015 to 2017, were examined. Questionnaires and characterization sheets were also used to obtain and record the information. The overall prevalence rate observed was 2.8%. The highest prevalence rates were observed in girls with medium length hair. Children presented a relatively low prevalence of head lice in the parasitological examinations. However, the answers to the questionnaires indicated that this ectoparasitosis is common in this population group. All the children examined were of school age, and their parents or guardians indicated the school environment as the main source of infestations. The responses to the questionnaires also highlighted evidence of negligence on the part of guardians of positive children regarding the occurrence of this ectoparasitosis. The information obtained indicates that authorities should design/improve their plans of action regarding guidelines for parents or guardians for adequate prevention and control of this ectoparasitosis

Pediculus capitis en niños de escuelas de la zona urbana de Nuevo León, México: análisis de factores asociados / Pediculus capitis in schoolchildren of the urban area of Nuevo León, México: Analyses of associated factors

Resumen Introducción. La pediculosis capitis es un problema recurrente que afecta anualmente de 6 a 12 millones de niños; no existen datos epidemiológicos en el estado de Nuevo León, y en México son escasos, por lo cual se necesitan estudios fundamentados para diseñar estrategias de control basadas en los factores que predisponen a la infestación por piojos. Objetivo. Determinar la prevalencia de Pediculus capitis en niños de educación primaria para detectar factores de riesgo y conocer las características individuales y las condiciones socioeconómicas asociadas estadísticamente con la infestación. Materiales y métodos. Se incluyeron 840 escolares de seis municipios, previa firma del consentimiento informado por parte de los padres y de los niños. Los ectoparásitos se recolectaron en cada niño infestado utilizando un peine fino. Los participantes contestaron una encuesta que incluía variables individuales y socioeconómicas, como la edad, el sexo, el grado escolar, las características del cabello, el hacinamiento y la pediculosis en hermanos, entre otras. Resultados. La prevalencia de pediculosis capitis en los niños fue de 28 % (235/840), con una mayor prevalencia en las niñas (33,7 %; 140/417); los niños del quinto grado (10 a 11 años) fueron los más afectados (6,2 %; 52/840). El sexo femenino, el cabello largo y el nivel escolar de los padres se asociaron significativamente con la pediculosis capitis. Conclusiones. Los resultados demostraron que la prevalencia de pediculosis capitis en Nuevo León es una de las más altas de México y que es un problema real de salud pública,por lo cual es importante establecer programas de prevención en la escuela y en el hogar para disminuirla o controlarla con la ayuda de las autoridades de salud pública.

Abstract Introduction: Pediculosis capitis is a recurring problem affecting 6 to 12 millions of children annually; there are no epidemiological data on this subject in the state of Nuevo León, and there are few in México. Therefore, new contributions are needed to design control strategies based on factors that may predispose to head lice infestation. Objective: To determine the prevalence of Pediculus capitis in primary school children and to evaluate risk factors and individual or socioeconomic characteristics statistically associated with infestation. Materials and methods: We included 840 schoolchildren from six municipalities after parents and children signed an informed consent. Ectoparasites were collected from infested children using a fine-toothed comb. Participants were interviewed using a questionnaire on individual and socioeconomic variables including age, gender, education, hair characteristics, overcrowding, and siblings with pediculosis, among others. Results: The overall prevalence of head lice in schoolchildren was 28% (235/840), the highest prevalence was among girls (33.7%, 140/417), and children from the fifth grade (10-11 years old) were the most affected (6.2%; 52/840). Female gender, long hair and the father's education level were significantly associated with P. capitis. Conclusion: Our results showed that the P. capitis prevalence in Nuevo León is one of the highest in Mexico, that it constitutes a real public health problem,and that there is need to establish prevention programsat home and school to decrease or to controlP. capitis with the support of public health authorities.

Head lice in school children in Uberlandia, Minas Gerais state, Brazil

School-aged children have shown to be the group most susceptible to Pediculus capitis infestation, possibly due to their habits and behaviors. The purpose of the study was to verify the prevalence of head pediculosis in preschool children from Uberlândia, MG, and factors associated with infestation. The children's parents or guardians were also evaluated regarding socioeconomic status, knowledge of symptomatology and control of this ectoparasitosis. Data were obtained by direct examination of each child's head and a questionnaire answered by parents/guardians. The overall prevalence rate was 7.5% among the 372 children examined, and 4 to 5-year-old girls with long hair presented significantly higher prevalence rates. Information from the questionnaires indicated that 45% of the children had already been infested at least once and the main symptom mentioned was intense itching on the scalp. Those responsible mostly used natural control measures to control infestations. The results indicated that children under the age of six should also be included in head pediculosis control programs

Piedra blanca en pacientes de centros dermatológicos de Pereira / Report of cases of white stone in patients of dermatological centers from Pereira

La piedra blanca es una micosis superficial crónica y asintomática poco frecuente del pelo causada por Trichosporon spp. (T. asahii, T. cutaneum o T. beigelii, T. inkin y T. mucoides), caracterizada por presentar nódulos blandos, blanquecinos, adheridos a los tallos pilosos, preferentemente del cuero cabelludo, axilas, cejas, pestañas y con menor frecuencia, en la barba, el bigote, el pubis y el perineo. Suele aparecer con mayor frecuencia en población de climas templados y tropicales. En los tres casos reportados se tomó muestra de los cabellos con los nódulos sospechosos, se le realizaron pruebas diagnósticas que permitieron confirmar la presencia de estructuras levaduriformes compatibles con Trichosporon spp. La sospecha de pediculosis es el motivo de consulta de los pacientes con piedra blanca, confundiendo los nódulos con liendres; por consiguiente es importante que el médico tenga claro las enfermedades micóticas con las cuales se debe hacer el diagnóstico diferencial para poder orientar y establecer el adecuado tratamiento para el paciente

The white stone is a rare, superficial, chronic and asymptomatic mycosis of the hair caused by Trichosporon spp. (T asahii, T. cutaneum or T. beigelli, T. inkin, and T. mucoid), which is characterized by the presence of white soft nodules, adhered to the hair shafts, preferably the scalp, armpits, eyebrows, eyelashes, and less frequently, in the beard, moustache, pubic area and perineum. It usually appears with greater frequency in areas of temperate and tropical climates. In the three reported cases, the sample of hair was taken from suspect hair, and then a series of diagnostic tests were performed to allow the confirmation of the presence of yeast shaped structures compatible with Trichosporon spp. Often, a possible pediculosis was the main reason of consultation of the patients who suffer white stone, and it can be confused with nodules of nits. Therefore, it is important that the physician has a better understanding of the fungal diseases that will be part of the differential diagnosis in order to guide and establish a proper treatment for the patients

Safety, Efficacy, and Physicochemical Characterization of Tinospora crispa Ointment: A Community-Based Formulation against Pediculus humanus capitis

The high prevalence of pediculosis capitis, commonly known as head lice (Pediculus humanus capitis) infestation, has led to the preparation of a community-based pediculicidal ointment, which is made of common household items and the extract of Tinospora crispa stem. The present study aimed to evaluate the safety, efficacy, and physicochemical characteristics of the T. crispa pediculicidal ointment. The physicochemical properties of the ointment were characterized, and safety was determined using acute dermal irritation test (OECD 404), while the efficacy was assessed using an in vitro pediculicidal assay. Furthermore, the chemical compounds present in T. crispa were identified using liquid-liquid extraction followed by ultra-performance liquid chromatography quadruple time-of-flight mass spectrometric (UPLC-qTOF/MS) analysis. The community-based ointment formulation was light yellow in color, homogeneous, smooth, with distinct aromatic odor and pH of 6.92±0.09. It has spreadability value of 15.04±0.98 g·cm/sec and has thixotropic behavior. It was also found to be non-irritant, with a primary irritation index value of 0.15. Moreover, it was comparable to the pediculicidal activity of the positive control Kwell®, a commercially available 1% permethrin shampoo (P>0.05), and was significantly different to the activity of the negative control ointment, a mixture of palm oil and candle wax (P<0.05). These findings suggested that the community-based T. crispa pediculicidal ointment is safe and effective, having acceptable physicochemical characteristics. Its activity can be attributed to the presence of compounds moupinamide and physalin I.