Ectoparasites: Pediculosis and tungiasis

Sarah J. Coates, Cristina Thomas, Olivier Chosidow, Daniel Engelman, Aileen Y. Chang

Research output: Contribution to journalReview articlepeer-review

35 Scopus citations


Pediculosis is an infestation of lice on the body, head, or pubic region that occurs worldwide. Lice are ectoparasites of the order Phthiraptera that feed on the blood of infested hosts. Their morphotype dictates their clinical features. Body lice may transmit bacterial pathogens that cause trench fever, relapsing fever, and epidemic typhus, which are potentially life-threatening diseases that remain relevant in contemporary times. Recent data from some settings suggest that head lice may harbor pathogens. The epidemiology, clinical manifestations, and management of body, head, and pubic louse infestation are reviewed. New therapies for head lice and screening considerations for pubic lice are discussed. Tungiasis is an ectoparasitic disease caused by skin penetration by the female Tunga penetrans or, less commonly, Tunga trimamillata flea. It is endemic in Latin America, the Caribbean and sub-Saharan Africa and seen in travelers returning from these regions. Risk factors for acquiring tungiasis, associated morbidity, and potential strategies for prevention and treatment are discussed.

Original languageEnglish (US)
Pages (from-to)551-569
Number of pages19
JournalJournal of the American Academy of Dermatology
Issue number3
StatePublished - Mar 2020
Externally publishedYes


  • Pediculus capitis
  • Pediculus humanus
  • Phthirus pubis
  • Tunga penetrans
  • Tunga trimamillata
  • body lice
  • ectoparasite
  • epidemic typhus
  • flea
  • head lice
  • homeless
  • homelessness
  • infestation
  • lice
  • pediculosis
  • poverty
  • pubic lice
  • refugee
  • relapsing fever
  • returning traveler
  • trench fever
  • tungiasis

ASJC Scopus subject areas

  • Dermatology


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