Pediculosis Corporis: An Overview

Introduction:

Lice and other parasitic organisms that thrive on human blood can manifest in the head, body, and pubic area (the area around the sexual organs on the outside of a human body). Body lice differ from those found on the head and the pubic area. Body lice can be found only in the body of humans. Animals or pets like dogs and cats are not involved in the spread of human lice. The only host of body lice is humans, and these cannot live more than five to seven days after they fall off from an individual.

What Are the Three Types of Lice That Affect Humans?

The three types of lice are as follows:

• Body louse (Pediculus humanus corporis).

• The head louse (Pediculus humanus capitis).

• Pubic louse (Pthirus pubis).

What Are the Three Stages of Body Lice?

The following are the three stages of body lice:

• Nit: Nits are usually oval-shaped and yellow-white colored lice eggs. They are very small and hence cannot be seen with the naked eye. Nits are present in the seams of the clothing and hatch within one to two weeks.

• Nymph: Nymphs are lice that are in the adolescent stage and hatch from nits. These are smaller in size than adult lice but they grow into adults after feeding on blood for 9-12 days.

• Adult Louse: An adult louse appears yellow-gray or brown-red in color. They are about 3 mm (millimeter) in size which is approximately the size of a sesame seed. Female lice are usually larger in size than male lice and have the potential to lay over 300 nits during their entire lifetime. The lifespan of body lice is about 20 days. If an adult louse is deprived of human blood for 1-2 days, it can die.

Unlike head and pubic lice, body lice live and reproduce in the clothing and then gain entry into the human body.

Who Is Prone to Get Infected With Body Lice?

There is no specific target population for the body lice to attack. They can manifest in people of all ages, races, and sex. The following people are more prone to getting infected with body lice:

• People living in areas of poor sanitary conditions, who do not have access to clean clothes, bedsheets, pillowcases, blankets, personal hygiene products, and so on.

• Refugees.

• Victims of war.

• Victims of natural disasters.

• People who do not have a house to stay.

What Is the Appearance of Body Lice?

The body louse is comparatively larger than the head louse and is around 2 to 4 mm in size. They appear white to grey in color and are flat. They do not live in the body of humans but rather crawl when they need to feed on blood. They can survive outside without a blood meal for up to 10 days. Body lice live and lay eggs on the cloth fibers, particularly on the seams, when they are not engaged in feeding. A female body louse has the ability to lay 10-15 eggs on clothing, and about 20 adult female lice can be found on an individual with the infestation.

What Is the Mode of Transmission of Body Lice?

Body lice lay their eggs and leave behind waste on a person's skin and clothing. These lice cannot hop, jump, or fly but can only crawl. Body lice can affect anyone and usually spread from one person to another through direct contact or sharing of towels, linens, or other clothing. They can affect the area of the body where the seams of the cloth are in contact with the skin, like the waist, armpits, groin, shoulders, and neck.

Can Body Lice Spread Diseases?

About thousands of mites may be involved in body lice manifestations, and each louse has the ability to bite an average of five times a day. At the time of feeding, the body lice invade the skin by biting and injecting a salivary anticoagulant and then suck the blood into their digestive tract. The bite of a body louse can be associated with various skin lesions like severe pruritus. This is characterized by severe itching of the skin as a result of the allergic or inflammatory reaction to the saliva of the louse. Profuse scratching due to itching can lead to skin abrasion and secondary bacterial infections. A few diseases caused by body lice are:

• Trench fever caused by Bartonella quintana. It is a bacterial infection that is characterized by weakness, fever, dizziness, headaches, and pain in the back and legs.

• Relapsing fever (bacterial infection) caused by Borrelia recurrentis that causes recurring fever, myalgia (muscle pains), nausea, and vomiting.

• Epidemic louse-borne typhus caused by Rickettsia prowazekii.

Trench fever and epidemic typhus do not spread through louse bites but through the infected feces, which the person can rub into the eyes, mucous membranes, or the bite site. Rickettsia prowazekii can be transmitted through the inhalation of aerosolized fecal dust, which can be a primary source of infection for clinicians. Borrelia recurrentis does not get transmitted through contaminated feces but rather when a person crushes the louse, and the bacteria invades the skin or the bite site. It can also spread if the person rubs their eyes or inserts the fingers in their mouth after crushing the louse.

What Are the Signs and Symptoms of Pediculosis Corporis?

The signs and symptoms of body lice infestation are as follows:

• Excessive itching (pruritus).

• Red bumps on the skin.

• Tickling feeling on the skin.

• A rash caused as a result of allergic reaction to body lice bites.

• Dark or thick skin is common near the groin or the waist if the lice have manifested there for a long time. This condition is called ‘Vagabond’s disease’.

• More severe symptoms include sores and infection.

How to Diagnose Pediculosis Corporis?

Body lice infestation can be diagnosed physically by observing the clothing and skin of crawling lice and eggs. They can be seen through a magnifying glass. A PCR (polymerase chain reaction) assay can help differentiate head and body lice but is mostly used for research purposes than for clinical diagnosis.

How to Manage Pediculosis Corporis?

Body lice infestation can be managed in the following ways:

• Improvement of personal hygiene by washing the clothes, bed linens, and towels frequently.

• The clothing, towels, and bed linens should be washed in hot water (129 Degrees Fahrenheit or 54 Degrees Celsius) and dried in hot air for at least 30 minutes.

• Pediculicides are medications that get rid of body lice. This is not required if the clothing, linens, and towels are laundered and changed frequently and if one follows appropriate personal hygiene.

• Lice-killing products can harm humans, so user instructions must be followed carefully.

• Bathing regularly with warm water and soap.

• Ironing the clothing and bedding by turning them inside out and focussing on ironing the seams.

• Carpets, mattresses, and furnitures must be vacuumed regularly, and the dust be emptied immediately into a trashcan.

• In a few cases, the healthcare provider may suggest oral antiparasitic medication like Ivermectin tablets or topical antiparasitic lotion, powder, cream, or shampoo like Permethrin.

• One must not scratch the body lice bite areas as it can increase the risk of skin abrasion and developing an infection. If the skin abrasion occurs accidentally, the affected area should be cleaned with soap and water and covered with a bandage to prevent infection.

• Over-the-counter Antihistamines and Hydrocortisone cream or ointment can offer relief from itching and swelling.

What Are the Home Remedies to Heal the Areas of Body Lice Bites?

The following are a few home remedies:

• Aloe Vera Gel: Aloe vera gel contains salicylic acid, which helps relieve pain and itching.

• Ice: Ice has the tendency to retard the amount of blood flowing to a particular area which reduces pain, swelling, itchiness, and inflammation. Ice packs covered in a light towel can be applied over the bitten area for at least 10 minutes for 3-4 times a day.

• Oatmeal: Oatmeal contains gluten which can offer relief to the area of body lice bites. The oatmeal must be mixed with warm water until it becomes a thick, sticky paste. This paste can be applied to the affected area. After 10 minutes, the area can be wiped with a clean towel.

What Are the Complications Associated With Body Lice Infestation?

A few complications include:

• Secondary infections through open wounds that are caused by scratching.

• Change in the thickness and color of the skin in case of prolonged infestation.

• Body lice are known to cause epidemics like typhus, and louse-borne relapsing fever, especially in poor sanitary conditions and places where war and poverty are prevalent.

Conclusion:

Pediculosis corporis or body lice infestations are common in areas with poor sanitation, lack of access to clean clothing, overcrowded areas, and in those who do not follow proper personal hygiene. The striking difference between head and body lice is that the body lice are capable of transmitting bacterial diseases like relapsing fever, trench fever, and epidemic typhus to humans. In case of infestation, it might take two weeks for the infestation to go away. Washing the clothing and bedding in hot water, changing the clothing, and taking a shower regularly can help get rid of body lice.