Pediatric emergency medicine trisk 1810 1810
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Blue macules (maculae caeruleae), caused by the bites, are 3 to 15 mm in
diameter and can be seen on the thighs, abdomen, or thorax of infested persons.
FIGURE 88.6 Louse.
Because the body louse resides in clothing, therapy consists mainly of
disinfecting the clothing with steam under pressure. Pediculosis capitis is usually
effectively treated with 1% permethrin or pyrethrin creme rinse though resistance
to this medication is not uncommon. The patient’s hair should be shampooed,
rinsed, and toweled dry. Enough medication to saturate the hair and scalp is
applied. The medication is washed out after 10 minutes. Additionally, benzyl
alcohol–containing products (Ulesfia) and topical ivermectin (Sklice) products
can also be used. Patients with resistant disease may also respond to topical
petrolatum applied to hair and scalp nightly for 1 week as a lice suffocant or
trimethoprim-sulfamethoxazole given orally for 5 to 7 days, which kills the
symbiotic parasite present in the GI tract of head lice. Pediculosis pubis is best
treated with the same permethrin or pyrethrin preparations used for head lice.
Any nits are removed with a fine-toothed comb. The safest treatment for lice in
the eyelashes is the application of Vaseline twice daily for 8 days. The lice stick
to the Vaseline, cannot feed, and die.
Vascular Papules and Nodules
Vascular papules and nodules can be congenital or acquired. Those in infants
generally fall in the category of benign with hemangiomas being most common.
