Phthiriasis Palpebrarum
An 8-year-old girl presented to the hospital with a 3-week history of itching of both eyelids. A physical examination showed redness of the eyelids. Slit-lamp examination revealed the presence of adult lice and nits on the eyelashes (Panel A). Microscopic examination of an eyelash (Panel B, and at higher magnification in Panel C) revealed the internal structure of nits. No lice or nits were found on other parts of the body or on examination of her parents. The lice were identified as Phthirus pubis, and a diagnosis of phthiriasis palpebrarum was made. An infestation of P. pubis can occur on eyelashes and pubic hairs; transmission can occur after contact with fomites or through sexual contact. An evaluation in this case revealed no evidence of sexual abuse. The lice and nits were mechanically removed. The bed linen and clothing of all the family members were washed in hot water separately from those of the patient, and shared use of household items was restricted. The itching of the eyelids resolved completely after treatment, and no lice or nits were seen at a follow-up visit 2 weeks later.
