Lice — Pubic Lice

Usually local to the genital area.
  • On hirsute person can crawl where body hair contiguous with pubic hair (up the belly, back, & down the thighs)
Transmission  —  usually during sex
  • Also other close skin-to-skin contact
  • Occupying a bed of infested person within 24 hours

Incubation period from contact to infestation —  2-3 weeks, for the 1 or 2 acquired lice to lay eggs (nits), & the nits to hatch.

Diagnosis
  • Seeing scurrying louse (usually hard to notice)
  • May see tiny white nits firmly attached to hairs
  • Distinguish nits from lint, etc., since nits can’t be flaked off
  • May need magnifying glass; much smaller than the nits of head lice. 
  • Maculae cerulae — small bluish macules stuck on skin (from enzymes in louse saliva)
Treatment failures common if only one dose of pediculocide is given
  • Preparations are NOT ovicidal; nits hatch in 10 days
  • Must apply a second treatment, exactly 11-12 days later, to kill any new nymphs before they mature (in >12 days) to lay new eggs.

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