New insights in pediculosis and scabies

www.expert-reviews.com ISSN 1746-9872 © 2009 Expert Reviews Ltd 10.1586/EDM.09.18 Human louse and scabies infestations are an ancient, common and well known medical problem of mankind. These ectoparasitic infestations have been, and unfortunately still are, associated with a perception of uncleanliness and social stigma. Despite their relatively ‘simple’ and straightforward nature, these infestations continue to be a significant public-health problem. The number of cases of human louse infestations has increased worldwide since the mid-1960s [1], reaching hundreds of millions annually [2]. The worldwide occurrence of scabies, with epidemics during war, famine and overcrowding, is responsible for an estimated 300 million people currently infested [3]. The aim of this review is to provide an upto-date summary of the biology, epidemiology, diagnosis, clinical aspects, prophylaxis and treatment of head lice and scabies. The discussion of body and pubic lice are beyond the scope of this review and accordingly they are mentioned only briefly. In January 2009 we searched the Medline database for the years 2004–2009 for the keywords Pediculus, pediculosis, scabies, Sarcoptes, pubic louse, phthiriasis and Pthirus, each separately. Those publications that had a special clinical and/or scientific interest were included in this review. Pediculosis capitis Despite the use of powerful insecticides and the prodigious efforts of parents and health providers, successful control of louse infestation remains unattainable in most countries. In developed countries, the high prevalence of head lice is due to a variety of reasons (for recent reviews see [4–8,201,202]), including: • Sale of ineffective pediculicides, potentially due to changes in formulation, manufacturing processes or ingredient sourcing over the years [9–11];