Question
This 22-year-old man presented with a 1-month history of severe pubic itch that was worst at night. What is the most appropriate topical treatment?
- Hydrocortisone
- Hydroxyzine
- Mupirocin
- Permethrin
- Selenium sulfide
-
Correct Answer : Permethrin
Explanation
The visible nits are consistent with pubic pediculosis.
The pubic louse is Phthirius pubis, the mature form of which is transferred during close body contact for example, sexual contact.
The major symptom is pruritus in the genital region especially in pubic hair. Examination may show the crab shaped adult louse which is brownish coloured and about 2 mm in diameter, or their ova - nits - which are a shiny white and the size of a pin head.
Diagnosis is made on the basis of the history and clinical examination.
The recommended treatments include permethrin or pyrethrin lotions. Alternative regimens to treat lice include topical malathion or oral ivermectin. Patients with pediculosis pubis should be evaluated for other sexually transmitted diseases