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Updated: Dec 16 2021

Pediculosis Pubis (Crabs)

  • Snap Shot
    • A 21-year-old female presents to her primary care physician after recently having unprotected sexual intercourse at a college party "a few weeks ago". She complains of intense genital pruritis that has been going on for the past 3 days. Nothing she has tried has alleviated the intense itching.
  • Presentation
    • History
      • pubic pruritis
      • sexual contact with someone diagnosed with pediculosis pubis
    • Symptoms
      • intense itching of the pubic area
        • due to parasitic saliva
        • becomes stronger over 2 or more weeks after initial infestation
        • other hairy areas of the body can be involved
      • pyoderma may develop from scratching
      • some patients are asymptomatic
  • Treatment
    • General
      • proper cleaning of clothing and bedding is necessary
    • Pharmacologic
      • permethrin 1% shampoo
        • apply to all hairy regions from the neck down
        • sexual partners should be treated as well
      • lindane
        • indications
          • 2nd line treatment due to toxicities
        • side effects
          • contraindicated in pregnancy
          • headaches
          • seizures
          • dizziness
          • convulsions
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