Pediculosis pubis and pediculosis ciliaris
- Adam O Goldstein, MD, MPH
Adam O Goldstein, MD, MPH
- Department of Family Medicine
- University of North Carolina at Chapel Hill
- Beth G Goldstein, MD
Beth G Goldstein, MD
- Adjunct Clinical Assistant Professor
- Department of Dermatology
- University of North Carolina at Chapel Hill
- Section Editors
- Robert P Dellavalle, MD, PhD, MSPH
Robert P Dellavalle, MD, PhD, MSPH
- Section Editor — Dermatology
- Professor of Dermatology and Public Health
- University of Colorado School of Medicine
- Colorado School of Public Health
- Chief, Dermatology Service
- US Department of Veterans Affairs
- Eastern Colorado Health Care System
- Moise L Levy, MD
Moise L Levy, MD
- Section Editor — Pediatric Dermatology
- Professor of Pediatrics and Medicine (Dermatology)
- Dell Medical School, University of Texas, Austin
- Clinical Professor of Dermatology and Pediatrics
- Baylor College of Medicine
Pediculosis pubis, pediculosis corporis, and pediculosis capitis are disorders caused by infestation by one of three varieties of lice that specifically infest humans (figure 1). Pediculosis pubis is usually sexually transmitted, and can extend beyond the pubic area to involve other areas of the body, including the eyelashes (pediculosis ciliaris). Phthirus pubis, also known as the crab louse, is the responsible organism.
The clinical findings, diagnosis, and treatment of pediculosis pubis and pediculosis ciliaris will be reviewed here. Pediculosis capitis and pediculosis corporis are discussed separately. (See "Pediculosis capitis" and "Pediculosis corporis".)
Epidemiology — Phthirus pubis, the crab louse, is usually transmitted during sexual contact, and increasing sexual freedom in many societies has contributed to its spread. Teenagers and young adults are most commonly affected.
Transmission via contact with fomites such as clothing, towels, or linen may also occur, but is thought to be less common [1,2]. Phthirus pubis gravitates toward warm environments and is not adapted to crawling on smooth surfaces, making infestation from a toilet seat unlikely .
A thorough sexual history and screening for other sexually transmitted diseases is warranted in patients with pediculosis pubis [3,4]. In a series of 121 individuals with pediculosis pubis, for example, 31 percent had another sexually transmitted disease . (See "Screening for sexually transmitted infections".)
- Galiczynski EM Jr, Elston DM. What's eating you? Pubic lice (Pthirus pubis). Cutis 2008; 81:109.
- Leone PA. Scabies and pediculosis pubis: an update of treatment regimens and general review. Clin Infect Dis 2007; 44 Suppl 3:S153.
- Chapel TA, Katta T, Kuszmar T, DeGiusti D. Pediculosis pubis in a clinic for treatment of sexually transmitted diseases. Sex Transm Dis 1979; 6:257.
- Pierzchalski JL, Bretl DA, Matson SC. Phthirus pubis as a predictor for chlamydia infections in adolescents. Sex Transm Dis 2002; 29:331.
- Kalter DC, Sperber J, Rosen T, Matarasso S. Treatment of pediculosis pubis. Clinical comparison of efficacy and tolerance of 1% lindane shampoo vs 1% permethrin creme rinse. Arch Dermatol 1987; 123:1315.
- Ragheb DA, Morsy TA, Abdalla HM, Abou Gamra MM. In vitro control of Phthirus pubis with four pediculocides: Eurax, Elimite, Licid and Benzanil. J Egypt Soc Parasitol 1995; 25:677.
- Stone SP, Goldfarb JN, Bacelieri RE. Scabies, other mites, and pediculosis. In: Fitzpatrick's Dermatology in General Medicine, 7th ed, Wolf K, Goldsmith LA, Katz SI, et al (Eds), McGraw Hill, 2008. p.2029.
- http://www.cdc.gov/parasites/lice/pubic/treatment.html (Accessed on January 07, 2013).
- Workowski KA, Bolan GA, Centers for Disease Control and Prevention. Sexually transmitted diseases treatment guidelines, 2015. MMWR Recomm Rep 2015; 64:1.
- Newsom JH, Fiore JL Jr, Hackett E. Treatment of infestation with Phthirus pubis: comparative efficacies of synergized pyrethrins and gamma-benzene hexachloride. Sex Transm Dis 1979; 6:203.
- Scott GR, Chosidow O, IUSTI/WHO. European guideline for the management of pediculosis pubis, 2010. Int J STD AIDS 2011; 22:304.
- Burkhart CG, Burkhart CN. Oral ivermectin for Phthirus pubis. J Am Acad Dermatol 2004; 51:1037; author reply 1037.
- Burkhart CN, Burkhart CG. Oral ivermectin therapy for phthiriasis palpebrum. Arch Ophthalmol 2000; 118:134.
- Speare R, Koehler JM. A case of pubic lice resistant to pyrethrins. Aust Fam Physician 2001; 30:572.
- Pubic "crab" lice. Centers for Disease Control and Prevention. www.cdc.gov/lice/pubic/index.html. (Accessed on January 24, 2010).
- Pinckney J 2nd, Cole P, Vadapalli SP, Rosen T. Phthiriasis palpebrarum: a common culprit with uncommon presentation. Dermatol Online J 2008; 14:7.
- Orkin M, Epstein E, Maibach HI. Treatment of today's scabies and pediculosis. JAMA 1976; 236:1136.
- Yoon KC, Park HY, Seo MS, Park YG. Mechanical treatment of phthiriasis palpebrarum. Korean J Ophthalmol 2003; 17:71.
- Ikeda N, Nomoto H, Hayasaka S, Nagaki Y. Phthirus pubis infestation of the eyelashes and scalp hairs in a girl. Pediatr Dermatol 2003; 20:356.
- Kumar N, Dong B, Jenkins C. Pubic lice effectively treated with Pilogel. Eye (Lond) 2003; 17:538.
- Mathew M, D'Souza P, Mehta DK. A new treatment of pthiriasis palpebrarum. Ann Ophthalmol 1982; 14:439.
- Ashkenazi I, Desatnik HR, Abraham FA. Yellow mercuric oxide: a treatment of choice for phthiriasis palpebrarum. Br J Ophthalmol 1991; 75:356.
- Klaus S, Shvil Y, Mumcuoglu KY. Generalized infestation of a 3 1/2-year-old girl with the pubic louse. Pediatr Dermatol 1994; 11:26.
- Kincaid MC. Phthirus pubis infestation of the lashes. JAMA 1983; 249:590.
- Burns DA. The treatment of Pthirus pubis infestation of the eyelashes. Br J Dermatol 1987; 117:741.
- Rundle PA, Hughes DS. Phthirus pubis infestation of the eyelids. Br J Ophthalmol 1993; 77:815.
- Raoult D, Roux V. The body louse as a vector of reemerging human diseases. Clin Infect Dis 1999; 29:888.
- Pe'er J, BenEzra D. Corneal damage following the use of the pediculocide A-200 Pyrinate. Arch Ophthalmol 1988; 106:16.
- PEDICULOSIS PUBIS
- Phthirus pubis
- Clinical manifestations
- Diagnosis and differential diagnosis
- - Treatment options
- - Resistance
- - Household members and fabrics
- PEDICULOSIS CILIARIS
- Clinical manifestations and diagnosis
- INFORMATION FOR PATIENTS
- SUMMARY AND RECOMMENDATIONS