Two species of blood sucking lice of the order Anoplura have evolved to be obligate ectoparasites of humans: Pediculus humanus and Phthirius pubis. The two variants of Pediculus, the head louse and the body louse, are similar morphologically but distinct in ecologic niches on the body and the clinical manifestations of infestation. The body louse may have evolved from the head louse after humans began to wear clothes.
Anyone may become louse infested under suitable conditions of exposure. Pediculosis is easily transmitted from person to person during direct contact. Head lice infestations are frequently found in school settings or institutions. Crab lice infestations can be found among sexually active individuals. Body lice infestation can be found in people living in crowded, unsanitary conditions where clothing is infrequently changed or laundered.
Usually, the first indication of an infestation is the itching or scratching in the area of the body where the lice feed. Scratching at the back of the head or around the ears should lead to an examination for head louse eggs (nits) on the hair. Itching around the genital area should lead to an examination for crab lice or their eggs. Scratching can be sufficiently intense to result in secondary bacterial infection in these areas.
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