Photo Rounds Friday Archive

Body itch

Post Date: 12/11/2009

FIGURE 1	FIGURE 2
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A 64-year-old woman with schizophrenia went to a homeless clinic because her whole body was itchy. She said that she could see creatures feeding on her and moving in and out of her skin. The physical exam revealed that she was unwashed and had multiple excoriations over her body.

What's your diagnosis?

The physician put on gloves and found body lice and their progeny visible along the seams of the patient’s pants (FIGURE 2).

Lice have 6 legs with terminal claws that enable them to attach to hair and clothing. Human lice must feed daily on blood and can only survive a day or 2 away from the host. The body louse (Pediculus humanus corporis) measures 2 to 4 mm in length.

The patient was given new clothes and she showered at the shelter. A pediculicide was not needed since her clothes were disposed of and she showered with soap and water.

Photos and text for Photo Rounds Friday courtesy of Richard P. Usatine, MD. This case was adapted from: Brookes L, Usatine R. Lice. In: Usatine R, Smith M, Mayeaux EJ, Chumley H, Tysinger J, eds. The Color Atlas of Family Medicine. New York, NY: McGraw-Hill; 2009:570-574.

To learn more about The Color Atlas of Family Medicine, see:
* http://www.amazon.com/Color-Atlas-Family-Medicine/dp/0071474641
* http://www.mhprofessional.com/product.php?isbn=0071474641