Dermatology Book

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Lice

Aka: Lice, Pediculosis, Pediculus humanus capitis, Pediculus humanus corpus, Phthirus pubis Infestation, Head Lice, Phthirus pubis, Body Louse Infestation, Pediculus Capitis Infestation, Body Lice, Genital Lice
  1. See Also
    1. Skin Infection
  2. Epidemiology
    1. Head and Body Lice are interchangeable
      1. Head Lice (Pediculus humanus capitis)
        1. Female lays eggs at base of hair
        2. Egg adheres as hair grows
        3. Transmitted by fomites or head to head contact
      2. Body Lice (Pediculus humanus corpus)
        1. Live in seams of clothing or bedding which they briefly leave only to feed on human host
        2. Transmitted by contact (most common in crowded living conditions with poor hygiene)
        3. May carry Typhus (Rickettsia)
    2. Genital Lice: Crab louse (Phthirus pubis)
      1. Typically seen in younger adults
      2. Often transmitted as Sexually Transmitted Disease
  3. Background
    1. Lice is not typically a sign of uncleanliness (exception is Body Lice in cramped living conditions)
    2. Lice does not typically transmit disease (rare exception is Body Lice and Typhus)
    3. Main effect of lice is one of embarrassment
    4. Lice do not jump or fly and are not passed by pets
  4. Epidemiology
    1. Head Lice will infect up to 10-40% of school children in the United States
    2. Greatest Incidence is in the Fall in U.S.
  5. Risk Factors
    1. Demographics
      1. Ages affected: 3 to 11 years
      2. Girls more affected than boys
      3. African Americans are uncommonly affected
    2. Hair type and color
      1. Brown or red hair color (more than black or blond)
      2. Fine hair
      3. Clean hair on healthy children
      4. Hair length is unrelated to lice infestation risk
  6. Pathophysiology: Lice Life Cycle
    1. Louse Lifetime: 1 month
    2. Lice feed on blood
      1. Typical feeding every 3-6 hours
      2. Survival 15-20 hours without a blood meal
      3. Survival beyond 48 hours without blood meal is rare
    3. Adult female may lay 150 eggs within 1 month (3-10/day)
      1. Female applies strong glue for nit attachment to hair
    4. Nits incubate
      1. Temperature >82 degrees Fahrenheit
      2. Humidity >70%
      3. Viable Embryo
        1. Shows movement within nit
        2. Eye spots may be seen on Embryo
    5. Nits hatch after 7-14 days of incubation
      1. Attach to Hair Shaft adjacent to scalp
      2. Hair Growth moves nit away from scalp
      3. Nit >0.25 inches from scalp is old nit
        1. Not active infestation
      4. Empty nit left when Embryo departs
        1. Distal nit appears flat (missing operculum)
        2. No movement from within nit and no eye spots seen
    6. Nymphs mature into adults by 3 stages over 12 days
    7. Lice life cycle repeats every 3 weeks
  7. Pathophysiology: Transmission
    1. Mechanism of transfer
      1. Lice cannot jump or fly
      2. Close contact person to person transmission
        1. Requires direct head contact
      3. Shared inanimate objects (nits survive <2 days)
        1. Combs
        2. Hats
        3. Brushes
        4. Towels
  8. Symptoms
    1. General
      1. Pruritus is due to allergy to louse Saliva
      2. Pruritus starts at least 2 weeks after infestation with first episode
        1. May be delayed up to 6 weeks with initial exposure
        2. Subsequent infestations are associated with Pruritus within the first 1-2 days after exposure
      3. May be accompanied by a nonspecific dermatitis (Erythematous Macules, Papules, wheals)
    2. Head Lice
      1. Pruritus at occiput, scalp, and post-auricular
    3. Body Lice
      1. Pruritus may lead to secondary infection
    4. Genital Lice
      1. Mild to severe regional Pruritus
  9. Signs
    1. Pearls for examination
      1. Use bright light and a magnifying glass for best visualization
      2. Consider combing the hair with a fine-toothed comb to identify lice
      3. Diagnosis of lice infestation relies on finding live lice
        1. Nits (lice eggs) alone are not sufficient for diagnosis
        2. Nits may remain on hair for months despite successful treatment
    2. Head Lice
      1. Nits visualized with greater ease than lice
        1. White dots or grains fixed to the Hair Shaft near their base
        2. Fluorescent under Wood Lamp
      2. Adult lice are 3-4 mm in size (sesame seed size)
      3. Locations (within 1 cm of scalp)
        1. Around and behind ears
        2. Nape of neck
      4. Associated findings
        1. Lymphadenopathy (esp. suboccipital)
    3. Body Lice
      1. Signs of secondary infection may occur
      2. Same size as Head Lice
    4. Genital Lice
      1. Much shorter than head and Body Lice
      2. Location
        1. Genital region and lower Abdomen
        2. Occasionally axillae or eyelashes
      3. Characteristics
        1. Maculae ceruleae (gray-blue Macules) may occur
  10. Differential Diagnosis
    1. Other cutaneous infestations (Scabies, Bed Bugs)
    2. Atopic Dermatitis (or Eczematous Dermatitis)
    3. Contact Dermatitis
    4. Seborrheic Dermatitis
    5. Superficial Folliculitis
    6. Tinea Capitis
  11. Complications
    1. Iron Deficiency Anemia
    2. Typhus, a Rickettsial infection (from Body Lice)
  12. Management: General
    1. Environmental care (prudent but not proven)
      1. Machine wash all washables (e.g. hats, linen, clothing) in hot water (122 F)
        1. Dry on hot cycle in dryer
      2. Store exposed un-washables in plastic bags for 2 weeks
      3. Vacuum all affected areas including furniture (no special carpet treatments needed)
      4. Soak combs and brushes in hot water (130 F) for 15 min
      5. Not necessary to fumigate or to spray furniture with pediculocides
    2. Screening exposures
      1. Examine family members and close school contacts and treat if lice identified
      2. Children should not miss school for lice infestation (per AAP)
      3. Treat sexual partners of those with Genital Lice (Pediculosis pubis)
  13. Management: Medications
    1. First-line Medications
      1. Precautions
        1. Resistance to topical Permethrin and Pyrethrin is very high in the U.S. as of 2014-2016
        2. Some argue these agents should no longer be used for lice
        3. Feldmeier (2014) Am J Clin Dermatol 15(5):401-12 +PMID: 25223568 [PubMed]
      2. Permethrin 1% (Nix) - OTC (effective in 90% of cases)
        1. Shampoo hair (no conditioner) and towel dry
        2. Apply Permethrin cream rinse and rinse in 10 min
        3. Safe down to age 2 months old
        4. Requires second treatment in 9-10 days (kills newly hatched lice)
      3. Pyrethrins with Piperonyl butoxide (Rid)
        1. Apply Shampoo to dry hair and rinse in 10 minutes
        2. Requires second treatment in 9-10 days
    2. Medications used in resistant cases
      1. FDA approved use for Lice (prescription only)
        1. Permethrin 5% (Elimite)
        2. Malathion (Ovide) 0.5%
          1. Avoid under age 6 years old (some use down to age 2 years)
          2. Apply to dry hair, air dry, and Shampoo off in 8-12 hours
          3. Use lice comb after application
          4. Single application is effective (but may repeat in 9-10 days if lice are still present)
          5. Disadvantages: Expensive and flammable
        3. Sklice
          1. Avoid under age 6 months old
          2. Single application is effective
        4. Natroba (Spinosad) 0.9%
          1. Avoid under age 4 years old
          2. Apply to dry hair, leave on for 10 minutes and rinse
          3. Single application is effective (but may repeat in 9-10 days if lice are still present)
          4. Disadvantages: very expensive
          5. Lice eradication rate (85%) is twice that of Permethrin
            1. Best efficacy is with nit combing
            2. Stough (2009) Pediatrics 124(3): e389-95 [PubMed]
        5. Ulesfia (benzyl Alcohol)
          1. Works by suffocating lice
          2. Avoid under age 6 months old
          3. May be used in pregnancy and Lactation
          4. Apply to dry hair, leave on for 10 minutes and then rinse
          5. Apply now and in 9-10 days
          6. Requires nit combing (see below)
          7. Comparable efficacy to first-line lice treatments at 3 times the cost
            1. Even more expensive in long hair
      2. Not FDA approved for Lice
        1. Dry-On Suffocation-based Pediculicide (Nuvo Lotion)
          1. Nuvo-Lotion is identical to Cetaphil (OTC)
          2. Applied to hair and hair blow-dried
          3. Nuvo Protocol Resource
            1. http://nuvoforheadlice.com
          4. Pearlman (2004) Pediatrics 114(3): e275-9 [PubMed]
        2. Trimethoprim-Sulfamethoxazole (Bactrim)
          1. Lower efficacy compared with other agents
        3. Ivermectin (Stromectol)
          1. Avoid in pregnancy, Lactation and in children weighing under 15 kg (33 lb)
          2. Initial Dose: 200 to 400 mcg/kg orally now and in 7 days
          3. Highly effective (95% eradication rate) and inexpensive
            1. Consider as second-line agent for refractory cases
            2. Chosidow (2010) N Engl J Med 362(10): 896-905 [PubMed]
    3. Medications in cases refractory to measures above
      1. Lindane (Gamma Benzene Hexachloride) 1%
        1. Not recommended due to neurotoxicity (Seizure risk, especially in children)
        2. Use only in adults >50 kg (not elderly) and only when other, safer options have been exhausted
    4. Specific Approaches
      1. Head Lice
        1. See Below
        2. Clean hats, brushes and combs, linen and bedding at high Temperature
        3. Examine family members and close school contacts and treat if lice identified
        4. Children should not miss school for lice infestation (per AAP)
      2. Body Lice
        1. Same pediculicidal agents used for Head Lice
          1. See first and second line agents as below
        2. Normal hygiene
        3. Clean hats, brushes and combs, linen and bedding at high Temperature
      3. Pediculosis pubis (Genital Lice)
        1. Permethrin 1% cream (Wash off in 10 minutes)
        2. Screen for other Sexually Transmitted Diseases
        3. Treat sexual partners
  14. Management: Protocol for Head Lice
    1. Identify Lice (See signs above)
    2. Use one of medications listed below (see above for descriptions of these agents)
      1. First Line
        1. Permethrin 1% (Nix) cream rinse
        2. Pyrethrins with Piperonyl butoxide (Rid)
      2. Second Line
        1. Malathion 0.5% topically (FDA approved) or
        2. Ivermectin (not FDA approved) or
        3. Permethrin 5% Cream
      3. Third Line
        1. Consider re-exposure instead of resistance
        2. Reinforce nit removal (see below)
        3. See numerous treatment options as above
        4. Option 1: Combination therapy
          1. Trimethoprim-Sulfamethoxazole (Bactrim) x10 days
          2. Permethrin 1% (2 applications, 7-10 days apart)
        5. Option 2: Monotherapy with one of agents below
          1. Malathion 0.5% topically (FDA approved)
          2. Ivermectin (not FDA approved)
    3. Remove nits with fine-toothed comb
      1. Use regular comb or brush first to detangle hair
      2. Consider using hair conditioner first
      3. Vinegar or 8% formic acid
      4. Fine-toothed comb (e.g. Licemeister Comb)
        1. http://www.licemeister.org
    4. Reapply medication and remove nits in 7-10 days
    5. Recheck hair for nits over 72 hours
  15. Management: Exposure
    1. Risk of transmission is low with casual contact
      1. Contacts have been exposed >1 month at diagnosis
      2. Children may attend school after treatment
      3. Nits are not a contraindication for school attendance
      4. Simply avoid direct head to head contact
    2. Avoid embarrassing child
      1. Notify child's parents immediately
      2. Keep diagnosis confidential
      3. Ensure prompt treatment and avoid missing school
    3. Treatment indications
      1. Check household exposures
        1. Live lice or eggs seen within 1 cm of scalp
        2. Treat family members who share same bed as child
      2. Head Lice screening programs are not recommended
        1. Do not reduce Head Lice Incidence
        2. Not cost effective
  16. Precautions: Alternative therapies that do not work well
    1. Mechanical "Bug-busting" (wet combing hair for 2 weeks)
    2. Petroleum jelly, Mayonaise, or kerosene (no evidence)
    3. Head shaving has only brief effect
  17. Resources
    1. National Pediculosis Association
      1. http://www.headlice.org
      2. Phone: 888-542-3634
    2. Lice Fighting Center (Commercial site)
      1. http://www.lice.com
  18. References
    1. Marco (2013) Crit Dec in Emerg Med 27(1): 2-7
    2. (2015) Presc Lett 22(9): 54
    3. (2012) Presc Lett 19(8): 46
    4. Angel (2000) Pediatr Clin North Am 47(4):921-35 [PubMed]
    5. Finders (2004) Am Fam Physician 69(2):341-50 [PubMed]
    6. Gunning (2012) Am Fam Physician 86(6): 535-41 [PubMed]
    7. Mumcuoglu (1999) Paediatr Drugs 1(3):211-8 [PubMed]
    8. Potts (2001) Postgrad Med 110(1):57-64 [PubMed]
    9. Ressel (2003) Am Fam Physician 67(6):1391-2 [PubMed]
    10. Roberts (2000) Lancet 356:540-4 [PubMed]
    11. Roberts (2002) N Engl J Med 346:1645-50 [PubMed]
    12. Roos (2001) Drugs 61(8):1067-88 [PubMed]

Lice Infestations (C0030756)

Definition (MSHCZE) Zavšivení. Na člověku parazitují tři druhy vší, nejčastěji veš vlasová. Způsobuje svědění hlavy a často se šíří v dětských kolektivech. Veš šatní může přenášet některé ricketsiózy (skvrnitý tyfus). Veš ohanbí (muňka) se přenáší zejm. pohlavním stykem. K odstranění vší existují průmyslově vyráběné přípravky na bázi insekticidů, důležitá je léčba celého kolektivu. (cit. Velký lékařský slovník online, 2013 http://lekarske.slovniky.cz/ )
Definition (MSH) Parasitic attack or subsistence on the skin by members of the order Phthiraptera, especially on humans by Pediculus humanus of the family Pediculidae. The hair of the head, eyelashes, and pubis is a frequent site of infestation. (From Dorland, 28th ed; Stedman, 26th ed)
Concepts Disease or Syndrome (T047)
MSH D010373
ICD9 132.9
ICD10 B85.2
SnomedCT 20848007, 187212006, 266223008, 154417001, 187207005, 187545007, 414618002, 74949007
English Pediculoses, Pediculosis, Pediculosis, unspecified, [X]Pediculosis, unspecified, Infestation, Lice, Infestations, Lice, Lice Infestation, Lice Infestations, pediculosis (diagnosis), pediculosis, Infestation by Pediculus, NOS, Pediculosis NOS, Lice Infestations [Disease/Finding], lice infestation, [X]Pediculosis, unspecified (disorder), Pediculosis + lice NOS, Pediculosis and other lice, Lice, Lice infestation, Infestation by Pediculus (disorder), Infestation by Pediculus, lice, Pediculus; infestation, infestation; Pediculus, Lice infestation, NOS, Louse infestation, Louse infestation (disorder)
Italian Infestazione da pidocchi, Pediculosi, non specificata, Pediculosi
Dutch pediculosis, pediculosis, niet-gespecificeerd, infestatie; pediculus, pediculus; infestatie, Pediculose, niet gespecificeerd, luizeninfestatie, Luisinfestatie, Pediculose
French Pédiculose, Pédiculose, non précisée, Pédiculoses, Phtiriase, Infestations de poux
German Pediculose, Pediculose, unspezifisch, Pedikulose, nicht naeher bezeichnet, Befall durch Laeuse, Pedikulose, Läusebefall
Portuguese Pediculose NE, Infestação por piolhos, Infestações por Piolhos, Pediculose
Spanish Pediculosis no especificada, pediculosis, SAI, [X]pediculosis, no especificada (trastorno), [X]pediculosis, no especificada, infestación por Pediculus (trastorno), infestación por Pediculus, pediculosis, Infestación por piojos, infestación por piojos, infestación por piojos (trastorno), Pediculosis, Infestaciones por Piojos
Japanese シラミ症、詳細不明, シラミ寄生, シラミショウショウサイフメイ, シラミキセイ, シラミショウ, 虱症(シツショウ), シラミ寄生症, シラミ症, 虱寄生症, 虱症
Swedish Huvudlöss
Czech pedikulóza, zavšivení, Pedikulóza, Zavšivení, Blíže neurčená pedikulóza, pediculosis
Finnish Täisyys
Russian PEDIKULEZ, ПЕДИКУЛЕЗ
Korean 상세불명의 이 감염증
Polish Inwazja wszy, Zarażenie wszą, Infestacja wszami, Wszawica
Hungarian tetű infestatio, pediculosis, pediculosis, nem meghatározott
Norwegian Pedikulose, Lusinfestasjon
Sources
Derived from the NIH UMLS (Unified Medical Language System)


Pediculus capitis infestation (C0030757)

Concepts Disease or Syndrome (T047)
ICD9 132.0
ICD10 B85.0
SnomedCT 271544006, 243682006, 81000006
English Pediculus capitis (head louse), Pediculus capitis - head lice, Pediculosis due to Pediculus humanus capitis, head lice (physical finding), head lice, pediculosis capitis (diagnosis), pediculosis capitis, Pediculus capitis infestation, Nits - head lice, Head pediculosis, Head-louse infestation, Infestation (by);lice;head, nits, pediculus capitis, head louse, head lice infestation, Head louse infestation (disorder), Pediculus capitis (organism), Pediculosis capitis, Head lice, Lice infested hair, Lousy hair, Nit infested hair, Nits, Head lice infestation, Head louse infestation, Pediculosis capitis (disorder), Pediculus humanus capitis; pediculosis, lice; head lice, pediculosis; Pediculus humanus capitis, Head louse, Pediculus capitis, Pediculus capitis [head louse]
Dutch hoofdluizen, pediculus capitis (hoofdluis), hoofdpediculosis, pediculosis capitis, Pediculus humanus capitis; pediculose, luizen; hoofdluis, pediculose; Pediculus humanus capitis, Pediculose door Pediculus humanus capitis
French Pédiculose du cuir chevelu, Pediculus capitis (poux de tête), Poux de tête
German Kopflaeuse, Pediculosis capitis, Pediculus capitis (Kopflaus), Pedikulose durch Pediculus humanus capitis
Italian Pediculosi del capo, Pediculus capitis (pidocchio del capo), Pidocchi del capo
Portuguese Piolhos da cabeça, Pediculus capitis (piolho da cabeça), Pediculose da cabeça
Spanish Pediculus capitis (piojo de la cabeza), Piojos en la cabeza, Pediculosis en cabeza, Pediculosis capitis, ftiriasis capitis, pediculosis capilar (trastorno), pediculosis capilar
Japanese アタマジラミ, アタマジラミ寄生, アタマジラミ, アタマジラミキセイ
Czech Pediculosis capitis, Zavšivení vší dětskou, Veš dětská, Zamoření vší dětskou
Korean 머리이에 의한 이 감염증
Hungarian Fej tetü, Pediculus capitis (fejtetű), Fej pediculosis, pediculosis capitis
Sources
Derived from the NIH UMLS (Unified Medical Language System)


Body louse infestation (C0030758)

Concepts Disease or Syndrome (T047)
ICD9 132.1
ICD10 B85.1
SnomedCT 25188002
English Pediculus corporis (body louse), Pediculus corporis - body lice, Pediculosis due to Pediculus humanus corporis, pediculosis corporis (diagnosis), pediculosis corporis, body lice, body lice (physical finding), Body louse infestation, Body pediculosis, Body-louse infestation, Infestation (by);lice;body, body louse, lice body, Body Lice, Pediculosis corporis, Body lice, Pediculosis corporis (disorder), Pediculus corporis infestation, Pediculus humanus infestation, Pediculus humanus corporis; pediculosis, lice; body lice, pediculosis; Pediculus humanus corporis, Body louse, Pediculus corporis, Pediculus corporis [body louse], body lice infestation
Dutch pediculosis corporis, lichaamspediculosis, lichaamsluizen, pediculus corporis (lichaamsluis), Pediculus humanus corporis; pediculose, luizen; kleerluis, pediculose; Pediculus humanus corporis, Pediculose door Pediculus humanus corporis
French Pediculus corporis (poux de corps), Poux corporels, Pédiculose corporelle, Pédiculose du corps
German Kleiderlaeuse, Pediculosis corporis, Pediculus corporis (Kleiderlaus), Pedikulose durch Pediculus humanus corporis
Italian Pediculosi corporea, Pediculosi del corpo, Pediculus corporis (pidocchio del corpo)
Portuguese Pediculose do corpo, Piolhos do corpo, Pediculus corporis (piolho do corpo)
Spanish Piojos corporales, Pediculosis corporal, Pediculosis corporis, Pediculus corporis (piojo del cuerpo), ftiriasis corporis, pediculosis corporis (trastorno), pediculosis corporis, pediculosis vestimenti
Japanese コロモジラミ, コロモジラミ寄生, コロモジラミ, コロモジラミキセイ
Czech Pediculosis corporis, Zavšivení vší šatní, Veš šatní, Zamoření vší šatní
Korean 몸이에 의한 이 감염증
Hungarian ruhatetü, Pediculus corporis (ruhatetű), Pediculosis corporis, pediculosis a testen
Sources
Derived from the NIH UMLS (Unified Medical Language System)


Infestation by Phthirus pubis (C0030759)

Definition (NCI) Infestation of the pubic hair by the pthirus pubis parasite which results in mild to intense itching and macular lesions. The parasite, also known as crab lice, is transmitted through skin to skin contact with an infected person or through direct contact with infested objects.
Concepts Disease or Syndrome (T047)
ICD9 132.2
ICD10 B85.3
SnomedCT 154420009, 187210003, 271545007, 243683001, 71011005
English Infestation by Phthirus pubis, Phthirus pubis - pubic lice, Crabs - pubic lice, pediculosis pubis (diagnosis), pediculosis pubis, pubic lice, pubic lice (physical finding), Pediculus pubis - pubic lice, Pubis pediculosis, Infestation by crab-louse, pubic louse, Infestation (by);lice;pubic, crab infestation, crab lice infestation, phthirus pubis, Phthirus/pediculus pubis - pubic lice - crabs (& infestation), Phthiriasis pubis (organism), Phthirus pubis (organism), Phthirus/pediculus pubis - pubic lice - crabs (& infestation) (disorder), Pediculosis pubis, Crabs, Phthiriasis pubis, Pubic lice, Infestation by crab lice, Crabs infestation, Pubic louse infestation, Infestation by Phthirus pubis (disorder), Phthirus pubis; pediculosis, infestation; pubic lice, lice; pubic lice, pediculosis; Phthirus pubis, pubic lice; infestation, Pediculosis Pubis, Phthirus pubis, Phthirus pubis [pubic louse], Pubic louse, Pediculus pubis, pubic lice infestation
Dutch pubis pediculosis, pediculosis pubis, Phthirus pubis; pediculose, infestatie; schaamluis, luizen; schaamluis, pediculose; Phthirus pubis, schaamluis; infestatie
French Pédiculose du pubis, Pédiculose pubienne
German Pediculosis pubis, Pubis pediculosis
Italian Pediculosi del pube, Pediculosi pubica
Portuguese Pediculose púbica
Spanish Pediculosis pubis, Pediculosis del pubis, infestación por Phthirus pubis (trastorno), infestación por Phthirus pubis, infestación por ladillas, ladillas, pediculosis pubis
Japanese ケジラミ寄生, ケジラミキセイ
Czech Pediculosis pubis, Pedikulóza ohanbí
Hungarian Pubis pediculosis, pediculosis pubis
Sources
Derived from the NIH UMLS (Unified Medical Language System)


Phthirus pubis (C0322635)

Concepts Eukaryote (T204)
MSH D020061
SnomedCT 45776000
English Phthirus pubis (pubic louse), Phthirus pubis, Phthirus pubis - pubic lice, Crabs - pubic lice, Crab Lice, Pediculus pubis - pubic lice, Crabs (pubic lice), Pthirus pubis (Linnaeus, 1758), Pthirus pubis, Louse, Crab, Crab Louses, Lices, Crab, Louses, Crab, Crab Lices, Lice, Crab, phthirius pubis, pubic lice, crab lice, pubic louse, phthirus pubis, pthirus pubis, crab louse, Phtirus pubis, genital louse, public louse, Crab, Crabs, Crab louse, Pubic lice, Pubic louse, Pediculus pubis, Pthirus inguinalis, Phthirus pubis (organism), Crab Louse, crabs
Dutch Phthirus pubis (schaamluis), platluizen, schaamluizen, Schaamluizen
French Phthirus pubis (poux du pubis), Poux pubiens, Morpions (poux pubiens), Phtirius pubis, Pou du pubis, Poux du pubis, Morpion
German Phthirus pubis (Filzlaus), Filzlaus, Filzlaeuse (Genitalbereich), Filzläuse, Phthirus pubis
Italian Phthirus pubis (pidocchio del pube), Pidocchi pubici, Pidocchio del pube, Pidocchi del pube
Portuguese Chatos (piolhos púbicos), Phthirus pubis (piolho púbico), Piolhos públicos, Chatos
Spanish Piojos púbicos, Phthirus pubis (piojo púbico), Phthirus pubis (organismo), piojo de los cangrejos, Phthirus pubis, Ladillas
Japanese ケジラミ寄生, ケジラミキセイ, ケジラミ, ケジラミ
Czech veš muňka, Veš muňka, Muňky (veš ohanbí), Muňky
Hungarian lapostetü, Lapostetű (Phthirus pubis), Phthirus pubis (lapostetű)
Norwegian Flatlus, Menneskets flatlus, Phthirus pubis
Sources
Derived from the NIH UMLS (Unified Medical Language System)


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