Trichoscopy: an update.

Hair and scalp disorders represent a substantial complaint in most dermatologists' daily practice. Trichoscopy is a simple and easy-to-perform technique that has been utilized for diagnosis and management of these patients. The interest for this technique had increased in the last years, and knowledge had expanded. This article reviews the most important dermoscopic patterns in normal Caucasian and African scalp, as well as in the most common trichological conditions.

Experimental evidence for costs due to chewing lice in the European bee-eater (Merops apiaster).

Animals frequently host organisms on their surface which can be beneficial, have no effect or a negative effect on their host. Ectoparasites, by definition, are those which incur costs to their host, but these costs may vary. Examples of avian ectoparasites are chewing lice which feed exclusively on dead feather or skin material; therefore, costs to their bird hosts are generally considered small. Theoretically, many possible proximate effects exist, like loss of tissue or food, infected bites, transmission of microparasitic diseases or reduced body insulation due to loss of feathers, which may ultimately also have fitness consequences. Here, we experimentally examined a possible negative impact of 2 feather-eating louse species (Meropoecus meropis and Brueelia apiastri) on male and female European bee-eaters (Merops apiaster) by removing or increasing louse loads and comparing their impact to a control group (lice removed and immediately returned) after 1 month. A negative effect of chewing lice was found on body mass and sedimentation rate and to a lesser extent on haematocrit levels. Males and females lost more weight when bearing heavy louse loads, and were more susceptible to infestations as indicated by the higher sedimentation rate. Our results further suggest differences in sex-specific susceptibility.

Circumscribed alopecia: an unusual manifestation of pediculosis capitis.

A healthy 10-year-old girl was referred for evaluation of patchy hair loss on the scalp of longer than 6 months duration. She had been diagnosed and treated for head lice approximately 1 month before onset of the hair loss. Examination of the scalp showed discrete ovoid patches of hair loss at the vertex scalp. A scrape of the area of hair loss was performed, and a nit was visible on microscopic examination. Focal hair loss may represent an atypical manifestation of ongoing pediculosis capitis.

The feather holes on the barn swallow Hirundo rustica and other small passerines are probably caused by Brueelia spp. lice.

Barn swallows Hirundo rustica often have characteristic feather holes on wing and tail feathers. During the past 15 yr, several influential papers have been based on the assumption that these holes were chewed by the louse Machaerilaemus malleus. We gathered feather-hole data from barn swallows and other passerines at 2 sites in Hungary and correlated the presence of holes with louse infestations and, more specifically, with the occurrence of M. malleus versus other species of avian lice. The shape of frequency distribution of holes was left-biased, and this bias was more pronounced in large swallow colonies that in a random sample, in accordance with the view that the causative agent of the 'feather hole symptom' is a contagious macroparasite. However, both intra- and interspecific comparisons suggest that the causative agent of the symptom had probably been misidentified. The occurrence of Brueelia spp. 'wing lice' provides the best fit to the distribution and abundance of feather holes, both in barn swallows and across some other small passerines. This identification error does not challenge the results of the former evolutionary-ecological studies based on this model system, although it has important implications from the viewpoint of louse biology.

Temporal relationship between infestation with lice (Bovicola ovis Schrank) and the development of pruritic behaviour and fleece derangement in sheep.

Pruritic behaviour and deranged fleece are often used as indicators of sheep louse infestation but the exact relationship between infestation and the observation of signs of pruritus was unclear. Two studies were conducted to examine this association. In the first, 24 castrate Merino sheep were randomly assigned to six pens in groups of four and the sheep in three pens infested with 10 lice each on the right mid-side. Louse numbers were counted, fleece derangement scored and pruritic behaviour assessed periodically on each sheep until 38 weeks after infestation. In the second study a single moderately infested sheep was paddocked for 15 weeks with 32 uninfested sheep and louse numbers and fleece derangement monitored for 41 weeks. In the pen studies, differences between infested and non-infested sheep in fleece derangement and pruritic behaviour first became significant (p<0.05) at 8 and 14 weeks, respectively and at louse densities of 0.06 and 0.27 per 10 cm wool part. Some sheep showed definite signs of deranged fleece as early as 5 weeks after initial infestation. In the paddock studies, it took 37 weeks until lice were detected on all sheep in the flock. The correlation between louse numbers and fleece derangement score first became significant (r=0.44 and p<0.05) at 9 weeks after introduction of the lousy sheep, reached a maximum of r=0.79 (p<0.001) at 22 weeks when 84% of sheep had lice detected and the mean louse density was 0.29 per part, and then declined to r=0.12 (n.s.) at 41 weeks when all sheep were infested and the mean louse density was 3.04 per part. It is concluded that fleece derangement is a powerful early indicator of the presence of lice and that sheep may exhibit signs of pruritus well before lice can be readily found by direct inspection. Fleece derangement may be useful as a basis for establishing economic thresholds for the application of long wool treatments in developing louse infestations but appears to be a poor indicator of louse numbers once the infestation is advanced.

An immunohistochemical assessment of the cutaneous immune response to louse infestation in cattle.

Skin samples were taken from 10 experimental cattle exposed naturally, during a period extending over two winters, to Bovicola bovis and Solenoptes capillatus, five becoming infested and five being protected from infestation by repeated treatment with ectoparasiticides. Skin sections were examined histopathologically and immunohistochemically for expression of the immune cell markers CD3, CD4, CD8 and class II antigens of the major histocompatibility complex (MHC). Louse-infested cattle had a mixed infiltration of the superficial dermis and perifollicular regions with eosinophils and mononuclear cells. The skin of infested cattle differed from that of non-infested cattle in showing significantly more cells expressing CD3, CD4 and MHC class II (P<0.05). Many of the MHC class II(+) cells had dendritic morphology, suggesting active antigen presentation within the lesions. Louse infestations have previously been thought to produce a type 1 hypersensitivity response, mediated by Th2 lymphocytes. However, the increased number of lymphocytes and antigen-presenting cells observed in the present study suggests that in chronic infestation there is activation of local cell-mediated (Th1) immunity.

Lice induced immuno-oxidative wreckage of goats.

The present study aimed to evaluate the immuno-oxidative patho-biology of lice infestation in goats. Sixty goats were divided into five groups; sucking lice (Linognathus africanus) infested (Group 1, n=12), chewing lice (Bovicola caprae) infested-mild (Group 2, n=12), chewing lice (B. caprae) infested-moderate (Group 3, n=12), chewing lice (B. caprae) infested-severe (Group 4, n=12) and healthy control (Group 5, n=12). To assess the pathological changes, markers of oxidative stress (lipid peroxidation-LPO, reduced glutathione-GSH, superoxide dismutase-SOD, Catalase-CAT and total antioxidant capacity-TAC), the markers of immune status (Tumour necrosis factor alpha- TNF-α, Interleukin-10- IL-10, Transforming growth factor beta 1- TGF-ß1, ratios of TNF-α/IL-10 and TNF-α/TGF-ß1) and hemato-biochemical status were evaluated. Significant anemia, hypoglycemia, hypoproteinemia and hypoalbuminemia were observed in caprine pediculosis irrespective of the type of lice infested. Remarkably increased oxidative stress was observed in chewing lice infested goats and no significant changes in oxidative stress markers were observed in sucking lice infested goats. TGF-ß mediated suppression of Th1 and Th2 immune responses was observed in sucking lice infested goats; whereas, a Th2 cytokine dominant inflammatory response was observed in chewing lice infested goats. From the present study, it may be concluded that sucking lice infestation produces remarkable immunosuppression and chewing lice infestation produces significant oxidative stress and inflammatory responses in goats.

Pruritus and dermal response to insect antigens in sheep infested with Bovicola ovis.

This study examined the relationships among louse density, pruritus and dermal response to insect antigens in sheep infested with Bovicola ovis. Polypay and Columbia ewes were allocated to two groups, infested and naive, and louse densities and pruritus were monitored for 15 months. Ten months after the initial infestation, all sheep were tested for hypersensitivity on the midside and ears by intradermal injection of soluble extracts of B. ovis, Stomoxys calcitrans and Musca autumnalis. The areas of skin reactions were measured at 20 min, 1, 3 and 24 h after injection and skin thickness was measured at 24 h. Louse densities on Polypays were approximately 10 times greater than on Columbias, and pruritus was correlated with louse numbers at most inspections. Most pruritic behaviour was directed to the sides of infested sheep. Wheal and flare reactions developed rapidly to all extracts in both infested and naive ewes. Reactions to louse extract were larger in infested than naive sheep at all four times after injection. In the infested Polypays, reactions to louse extract were greater than to the fly extracts, but in naive sheep there was little difference among extracts. Reactions in naive Columbias were larger than in naive Polypays at 20 min, 1 and 3 h, but had almost completely abated in both groups at 24 h. Reactions in infested Columbias were greater than in infested Polypays at 20 min, but at 24 h reactions in the Polypays were larger. Louse numbers and pruritus were correlated with wheal areas and skin thickness at 24 h, but there was little relationship with the size of reactions at earlier times. These findings are consistent with the development of a hypersensitive response to B. ovis and suggest that dermal reactions to lice may influence sheep susceptibility.

Yellow mercuric oxide: a treatment of choice for phthiriasis palpebrarum.

Thirty-five patients presenting with phthiriasis palpebrarum were all treated with a regimen of 1% yellow oxide of mercury ointment four times daily for 14 days. At the conclusion of treatment there was complete resolution of the signs and symptoms of the disease. No side effects due to the treatment were reported or detected. We have shown that 1% mercuric oxide ointment is both a safe and effective treatment for phthiriasis palpebrarum. We recommend it as the treatment of choice.

Clinical and hematological findings on "Degnala", a disease of buffalo in Eastern Nepal.

A buffalo disease, called "Degnala", causing lameness, edema, gangrenous ulceration of hooves or tail, emaciation, recumbency and eventual death, occurs in Eastern Nepal. Clinical examinations manifested lice eggs on hairs, bradycardia, hypothermia, dehydration, exanthema and icterus. Hematologically, increase of band neutrophil, giant platelet, hypoalbuminemia and hyperglobulinemia were characteristics. Microscopically, dark blue tiny particles were seen on red blood cell (RBC) after Giemsa staining. Administration of tetracycline at an early stage of the disease was effective.

Scabies, lice, and fungal infections.

Scabies and pediculosis capitis are frequent and often unrecognized causes of multiple streptococcal and staphylococcal pyodermas. Permethrin 1 per cent creme rinse (NIX) for head lice, and permethrin 5 per cent topical cream for scabies are new, highly effective, safe, and cosmetically elegant treatments which have shown superiority over older remedies. In populations in which pediculosis and scabies have resisted traditional lindane therapy, patients promptly responded to these permethrin products. Scabies in nursing homes is a persistent and expanding problem which demands a high level of diagnostic suspicion and an integrated approach to management. For fungal infections, several new broad-spectrum oral and topical agents have been introduced. Their successful use is enhanced by appropriate diagnostic tests which can be performed in the office setting. Recommendations and references are given to assist the physician in diagnosis and choice of therapy.

Ectoparasites from elk (Cervus elaphus nelsoni) from Wyoming.

Hides of nine elk, collected during the winter of 1986-1987 from the National Elk Refuge, Wyoming (USA) were examined for ectoparasites. Parasites recovered were mites, Psoroptes sp. (five elk); lice, Solenopotes ferrisi and Bovicola (Bovicola) longicornis (seven elk); and winter ticks, Dermacentor albipictus (nine elk). Three elk with severe scabies had an estimated 0.6 x 10(6), 3.8 x 10(6) and 6.5 x 10(6) mites, respectively. Densities of mites were much higher in skin regions with severe dermatitis. Skin lesions on elk with scabies consisted of dense, often moist, scabs extending along the dorsal and lateral thoracic regions of the body. Lesions attributed to winter ticks consisted of broken hair and alopecia on the dorsal portion of the lower neck, often extending in a "collar" around the neck.

Hair-loss syndrome in black-tailed deer of the Pacific Northwest.

A widespread hair-loss syndrome (HLS) has affected Columbian black-tailed deer (Odocoileus hemionus columbianus) in western Oregon and Washington (USA) since 1996. In order to better characterize the condition, 21 HLS-affected black-tailed deer (BTD) were necropsied, and body condition, parasite burdens, and significant lesions were noted. All deer were in poor body condition, and at least 17 had severe internal parasite burdens. A consistent finding was the presence of large numbers of chewing lice, identified as an indeterminate species of Damalinia (Cervicola). Four animals were infested with intrafollicular Demodex sp., the first report of this genus of mites in BTD. We postulate that the hair loss is largely due to ectoparasitism by a species of chewing louse that represents a new pathogen for BTD. This loss of pelage also may be an important contributor to the poor body condition of these animals.

Morphology of the leather defect light flecks and spots.

The skin histology and the scanning electron microscope morphology of the hide defect light flecks and spots after tanning were studied in 11 steers infested with biting lice (Damalinia bovis). Nine steers from herds free of lice were used as controls. Skin biopsies from 6 of the animals in the lice infested group showed mild to moderate hyperkeratosis and moderate perivascular to diffuse dermatitis with infiltration of mainly mononuclear cells and some eosinophilic granulocytes. The steers were slaughtered at an age of 18 to 23 months. Light flecks and spots occurred on all examined hides from the infested group after tanning. No examined hides from the control group demonstrated similar damage. Both light microscopic examination of sections of tanned hide with light flecks and spots and scanning electron microscopy of the same defects showed superficial grain loss and craters with a irregular fibre base encircled by smooth and intact grain. The association between louse infestation at an early age and damage of hides following slaughter 6 to 15 months later, suggested that louse infestations lead to a prolonged or lifelong weakening in the dermis. This weakening may cause superficial grain loss during the tanning process.