ICD-10: B85

Pediculosis and phthiriasis, classified under ICD-10 code B85, refer to infestations caused by lice, which are parasitic insects that can affect various parts of the body. Understanding the clinical presentation, signs, symptoms, and patient characteristics associated with this condition is crucial for effective diagnosis and treatment.

Clinical Presentation

Types of Pediculosis

Pediculosis can manifest in several forms, depending on the type of louse involved:

1. Pediculosis Capitis: Infestation of the scalp by head lice (Pediculus humanus capitis).
2. Pediculosis Corporis: Infestation of the body by body lice (Pediculus humanus corporis).
3. Pediculosis Pubis: Infestation of the pubic area by pubic lice (Pthirus pubis).

Each type presents with specific characteristics, but they share common symptoms related to itching and irritation.

Signs and Symptoms

Common Symptoms

• Itching: The most prominent symptom, caused by an allergic reaction to louse saliva. Itching can lead to scratching, which may result in secondary infections.
• Visible Lice or Nits: Adult lice are small, about 2-3 mm in size, and can be seen moving on the scalp, body, or pubic area. Nits (lice eggs) are oval and usually attached to hair shafts or clothing fibers.
• Inflammation and Redness: Scratching can cause inflammation, leading to redness and possible secondary bacterial infections.
• Rash: In some cases, a rash may develop due to scratching or as a reaction to the lice.

Specific Signs by Type

• Pediculosis Capitis: Often presents with small red bumps on the scalp and neck, and nits may be visible close to the scalp.
• Pediculosis Corporis: May present with itchy rashes on the body, particularly in areas where clothing fits tightly. Secondary infections can occur due to scratching.
• Pediculosis Pubis: Symptoms include itching in the genital area, and visible lice or nits in pubic hair. In some cases, it may also affect other coarse body hair, such as the armpits or chest.

Patient Characteristics

Demographics

• Age: Pediculosis capitis is most common in children aged 3 to 11 years, but it can affect individuals of any age. Body lice are more common in adults, particularly those with poor hygiene or living in crowded conditions. Pubic lice typically affect sexually active adults.
• Socioeconomic Status: Higher prevalence is often seen in lower socioeconomic groups due to factors such as overcrowding and limited access to hygiene resources.
• Hygiene Practices: Poor hygiene and infrequent washing of clothing and bedding can increase the risk of body lice infestations.

Risk Factors

• Close Contact: Infestations are often spread through close personal contact, making children in schools or daycare settings particularly vulnerable.
• Shared Personal Items: Sharing combs, hats, or clothing can facilitate the spread of lice.
• Travel: Traveling to areas with high rates of lice infestations can increase risk.

Conclusion

Pediculosis and phthiriasis, represented by ICD-10 code B85, encompass a range of lice infestations characterized by itching, visible lice or nits, and potential secondary infections. Understanding the clinical presentation, signs, symptoms, and patient characteristics is essential for healthcare providers to diagnose and manage these conditions effectively. Early identification and treatment can help alleviate symptoms and prevent further spread of infestations.

The ICD-10 code B85 refers to "Pediculosis and phthiriasis," which encompasses infestations caused by lice. This condition can affect various parts of the body, including the scalp, body, and pubic area. The diagnosis of pediculosis typically involves several criteria and considerations, which are outlined below.

Diagnostic Criteria for Pediculosis (ICD-10 Code B85)

1. Clinical Presentation

• Symptoms: Patients often present with itching, which is a common symptom due to allergic reactions to louse saliva. Scratching may lead to secondary infections.
• Visible Lice: The presence of adult lice or nits (eggs) on hair shafts or clothing is a key diagnostic criterion. Adult lice are small, wingless insects, while nits are oval and usually yellow or white.
• Location of Infestation: The specific type of lice can indicate the area affected:
  • Pediculus humanus capitis: Scalp lice, primarily affecting the head.
  • Pediculus humanus corporis: Body lice, typically found in clothing and affecting the body.
  • Pthirus pubis: Pubic lice, commonly found in the pubic region.

2. History Taking

• Exposure History: A thorough history should include potential exposure to infested individuals, environments, or shared personal items (e.g., hats, combs, bedding).
• Duration of Symptoms: Understanding how long the symptoms have been present can help in assessing the severity and potential treatment options.

3. Physical Examination

• Scalp and Body Inspection: A detailed examination of the scalp, body, and pubic area is essential. This includes looking for lice, nits, and signs of scratching or secondary infections.
• Dermatological Signs: The presence of excoriations, inflammation, or secondary bacterial infections may also be noted during the examination.

4. Differential Diagnosis

• Exclusion of Other Conditions: It is important to differentiate pediculosis from other conditions that may cause similar symptoms, such as scabies, dermatitis, or other skin infections. This may involve additional tests or evaluations.

5. Laboratory Tests (if necessary)

• While not routinely required, laboratory tests may be used in atypical cases or when secondary infections are suspected. These could include skin scrapings or cultures to rule out other infections.

Conclusion

The diagnosis of pediculosis (ICD-10 code B85) is primarily clinical, relying on the identification of lice or nits, patient history, and physical examination findings. Understanding the specific type of lice involved and the areas affected is crucial for effective management and treatment. If you suspect an infestation, it is advisable to consult a healthcare professional for an accurate diagnosis and appropriate treatment options.

Pediculosis, commonly known as lice infestation, is classified under the ICD-10 code B85. This condition can affect various parts of the body, with the most common types being head lice (Pediculus humanus capitis), body lice (Pediculus humanus corporis), and pubic lice (Pthirus pubis). The treatment approaches for pediculosis typically involve both pharmacological and non-pharmacological strategies aimed at eradicating the lice and managing symptoms.

Pharmacological Treatments

1. Topical Insecticides

The primary treatment for pediculosis involves the use of topical insecticides. These are available over-the-counter or by prescription and include:

• Permethrin: A synthetic pyrethroid that is effective against lice. It is typically applied to the scalp and hair for 10 minutes before rinsing. A second application may be necessary after 7-10 days to kill any newly hatched lice[1].

• Pyrethrins with Piperonyl Butoxide: This combination product is also effective and works similarly to permethrin. It is applied to the hair and scalp and left on for 10 minutes before rinsing[2].

• Malathion: An organophosphate insecticide that is effective against lice. It is applied to dry hair and left on for 8-12 hours before washing out. Malathion is typically used when other treatments fail due to its higher toxicity[3].

• Ivermectin: Available as a topical lotion, ivermectin is used for patients who do not respond to other treatments. It is applied to dry hair and left on for 10 minutes[4].

2. Oral Medications

In cases of severe infestation or treatment-resistant lice, oral medications may be prescribed:

• Ivermectin: In oral form, it is used for patients with extensive infestations or those who have not responded to topical treatments. It is typically given as a single dose, with a possible repeat dose after a week[5].

Non-Pharmacological Treatments

1. Manual Removal

Manual removal of lice and nits (eggs) is an essential part of treatment. This can be done using a fine-toothed comb, which should be used on wet hair to facilitate the removal process. It is recommended to comb through sections of hair meticulously to ensure all lice and nits are removed[6].

2. Environmental Control

To prevent reinfestation, it is crucial to address the environment:

• Washing: Clothing, bedding, and personal items should be washed in hot water and dried on a high heat setting to kill any lice or nits that may be present[7].

• Vacuuming: Carpets, furniture, and car seats should be vacuumed to remove any fallen lice or nits[8].

• Avoiding Sharing Personal Items: Educating individuals about not sharing combs, hats, or other personal items can help prevent the spread of lice[9].

Conclusion

Effective management of pediculosis (ICD-10 code B85) involves a combination of pharmacological treatments, such as topical insecticides and, in some cases, oral medications, along with non-pharmacological strategies like manual removal and environmental control. It is essential to follow treatment guidelines carefully and to repeat treatments as necessary to ensure complete eradication of lice. If infestations persist despite treatment, consulting a healthcare provider for further evaluation and alternative therapies is advisable.

Clinical Description of ICD-10 Code B85: Pediculosis and Phthiriasis

ICD-10 code B85 refers to pediculosis and phthiriasis, which are infestations caused by lice. This condition is characterized by the presence of lice on the human body, scalp, or pubic area, leading to various symptoms and complications.

Types of Lice

1. Head Lice (Pediculus humanus capitis):
   - Commonly found on the scalp and hair.
   - Symptoms include itching, irritation, and the presence of nits (lice eggs) attached to hair shafts.

2. Body Lice (Pediculus humanus corporis):
   - Typically found on clothing and can move to the skin to feed.
   - Associated with poor hygiene and crowded living conditions.
   - Can lead to secondary infections due to scratching.

3. Pubic Lice (Pthirus pubis):
   - Found in the pubic hair and can also infest other coarse body hair.
   - Symptoms include itching and inflammation in the affected areas.

Clinical Presentation

• Symptoms: The primary symptom of pediculosis is intense itching, which results from an allergic reaction to louse saliva. Scratching can lead to secondary bacterial infections, skin irritation, and inflammation.
• Diagnosis: Diagnosis is typically made through physical examination, where lice or nits are identified in the hair or on the skin. In some cases, a thorough history of exposure may also be considered.

Complications

While pediculosis is generally not life-threatening, it can lead to several complications, including:
- Secondary Infections: Scratching can break the skin, leading to bacterial infections.
- Psychosocial Impact: The stigma associated with lice infestations can lead to anxiety and social withdrawal, particularly in children.

Treatment

Treatment for pediculosis typically involves:
- Topical Insecticides: Over-the-counter or prescription treatments that kill lice and nits.
- Manual Removal: Combing the hair with a fine-toothed comb to remove lice and nits.
- Environmental Control: Washing clothing and bedding in hot water and vacuuming living areas to eliminate lice and eggs.

Clinical Relevance

Understanding the clinical aspects of pediculosis is crucial for effective management and prevention. Public health education plays a significant role in reducing the incidence of lice infestations, particularly in schools and communal living environments[6][11][15].

Conclusion

ICD-10 code B85 encompasses a range of lice infestations that can affect individuals of all ages. While the condition is treatable, awareness and education are essential to prevent outbreaks and manage infestations effectively. If you suspect a lice infestation, it is advisable to consult a healthcare provider for appropriate diagnosis and treatment options.

ICD-10 code B85 encompasses conditions related to pediculosis and phthiriasis, which are infestations caused by lice. Understanding the alternative names and related terms for this code can enhance clarity in medical documentation and communication. Below is a detailed overview of these terms.

Alternative Names for Pediculosis and Phthiriasis

1. Pediculosis

• Lice Infestation: A general term that refers to the presence of lice on the body, scalp, or pubic area.
• Head Lice: Specifically refers to infestations caused by Pediculus humanus capitis, the louse that primarily infests the scalp.
• Body Lice: Refers to infestations caused by Pediculus humanus corporis, which typically inhabit clothing and are associated with poor hygiene.
• Pubic Lice: Also known as "crabs," this term refers to infestations caused by Pthirus pubis, which primarily affects the pubic region.

2. Phthiriasis

• Phthiriasis Palpebrarum: A specific term for lice infestation affecting the eyelashes and eyelids.
• Phthiriasis Pubis: Refers specifically to pubic lice infestation, often used interchangeably with "crabs."

Related Terms

• Lice: A common term that encompasses all types of lice, including head, body, and pubic lice.
• Infestation: A term used to describe the presence of parasites, such as lice, on a host.
• Pediculosis Capitis: A more specific term for head lice infestation.
• Pediculosis Corporis: A term used for body lice infestation.
• Pediculosis Pubis: Refers specifically to pubic lice infestation.

Conclusion

The ICD-10 code B85 serves as a classification for various forms of lice infestations, including pediculosis and phthiriasis. Understanding the alternative names and related terms is crucial for accurate diagnosis, treatment, and communication in medical settings. This knowledge aids healthcare professionals in ensuring clarity and precision when discussing these conditions.