Pubic Lice Infestation (Pediculosis Pubis) on Darker Skin

00:01 The last one is pubic lice or pthirus pubis.

00:05 It most commonly affects sexually active individuals.

00:10 The incidence seems to be decreasing due to the rising popularity of pubic hair removal, which is suggested as a potential contributor to the decreasing incidence of pubic lice.

00:24 It's usually via sexual contact, and indirect transmission through fomites can occur, but is less common.

00:33 Clinically, patients may present with pruritus, which is a main symptom, and the pubic area and perianal area are the sites that are most commonly affected.

00:47 Clinical manifestations include pale bluish macula, which develop due to injection of anti-coagulant saliva during louse feeding.

00:57 So the lice produces an anticoagulant.

01:00 Hence, you see the bluish macules on the skin.

01:06 The feces of the lice can also be seen on the skin.

01:12 And it can also present with pediculosis cellaris, which is involvement of the palpebral, that is, the eyelashes. Reddish crusting matting of the lashes and conjunctivitis can be one of the clinical presentations.

01:32 The diagnosis is usually clinical.

01:35 You can see the egg and lice, and the differential diagnosis includes white piedra and scabies, just like the other types of lice.

01:47 Treatment includes topical pediculosis, permethrin and malathion, and removal of the nits with fingernails, nit comb, or tweezers. Oral ivermectin has also been used for patients with pubic lice.