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Phthiriasis palpebrarum: an unusual blepharoconjunctivitis.

Phthiriasis palpebrarum is an unusual cause of blepharoconjunctivitis and may easily be overlooked because of the failure of physicians to recognize Phthirus pubis. We report a case of a 30-year-old woman with persistent itching in the left eyelid which was unsuccessfully treated under the diagnosis of allergic blepharoconjunctivitis. Careful ophthalmic examination revealed seven bugs with multiple red pinpoint excretions and numerous small translucent oval eggs (nits) coating the eyelashes. The patient was successfully treated with mechanical removal of all the lice and nits from the eyelashes. The specimen proved histopathologically to be the Phthirus pubis infestation. The Phthirus pubis infestation is usually associated with poor hygiene in overcrowded or undeveloped country. However, it may become a notable problem because of frequent traveling and commercial activities across the different countries.

Adult↗

Ectoparasitic infestation of the lashes.

Phthirus pubis, commonly known as the crab louse, has as its habitat the pubic and inguinal regions of the body. Transfer between hosts is most commonly a result of sexual contact. On occasion, Phthirus pubis will leave its usual seat of predilection and infest other hair-bearing body parts. When infestation of the eyelashes occurs, it is known as phthiriasis palpebrarum. The case presented is an example of phthiriasis palpebrarum in a young female, apparently contracted as a result of transfer from the genital region of an affected male by hand contact.

Adolescent↗

A four years old girl with phthiriasis pubis infestation.

A four years old girl had Phthirus pubis infestation in the scalp, eyelids, eyelashes, neck and shoulders. She had fever, severe itching, allergic reaction and anxiety. The girl was successfully treated with 2.5% permethrin cream. The risk of lice infestation as a community health problem was discussed.

Animals↗

[Phthiriasis palpebrarum: diagnosis and treatment].

Phthiriasis palpebrarum, caused by Phthirus pubis, is an uncommon cause of blepharoconjunctivitis; therefore, this condition is easily misdiagnosed. When diagnosed, genital involvement must be ruled out. Association with other venereal diseases is common. Affected children must be searched for sexual abuse. The number of diagnosed patients in our department has increased in recent years. We review the epidemiological, clinical and diagnostic features of phthriasis palpebrarum as well as the different treatment options to eradicate the parasite and to prevent infestations.

Blepharitis↗

Phthiriasis palpebrarum: 2 case reports.

Phthiriasis palpebrarum, caused by the phthirus pubis, is a rare cause of blepharoconjunctivitis, and is therefore often neglected. We present 2 patients who suffered itching and irritation at the right upper eyelid. Biomicroscopic examination showed a few lice and nits anchored to the eyelashes. Dermatologic examination revealed the presence of numerous lice and nits at the trunk and pubic area. The lice and nits were manually removed if possible, and the patients were asked to put vaseline on the eyelid margins. The patients were also treated with malathion 0.5% lotion. After control, two weeks later, no more lice nor nits were present in the first patient.

Adult↗

Pediculosis pubis in a clinic for treatment of sexually transmitted diseases.

The symptoms, clinical findings, epidemiology, and associated sexually transmitted diseases are described for 121 patients with pediculosis pubis who were seen in a clinic. Phthirus pubis was observed in the pubic hair of 118 patients, and in 38 men (37.3%) and 18 women (94.7%) the pubic region was the sole area of involvement. Pruritus was reported by 104 patients (85.9%), while excoriations were observed in 30 (24.8%) and maculae ceruleae in one. The median waits from detection of organisms to presentation at the clinic were two days for men and one day for women. This motivation for medical care was fortuitous, because 31.4% of the patients infested with P. pubis had other sexually transmitted diseases.

Adolescent↗

Pediculosis and the pediatrician.

Head lice commonly evoke feelings of disgust, revulsion, anger, and shame among parents and patients. There should, however, be no great cause for such alarm if a physician suspects pediculosis capitis. The recent introduction of several new pediculicidal drugs now allows a choice among four distinct therapeutic agents, which should substantially improve control of isolated cases and epidemics. Physicians must be aware that consumer groups are pressing public health authorities and drug manufacturers to establish proper treatment standards and safety warnings for the use of these agents. In addition, some controversy surrounds the use of lindane in children. This paper reviews the epidemiology and clinical appearance of pediculosis capitis in children, with emphasis on these recent developments. Pubic lice (Phthirus pubis) and body lice (Pediculus humanus corporis), both of which are much less common pediatric infestations, are mentioned only briefly.

Child↗

Sociodemographic factors associated with Pediculosis capitis and pubis among young adults in the Israel Defense Forces.

While socioeconomic factors have been found to be important in the incidence of head lice (Pediculosis capitis) infestation, most reports pertain to children. Furthermore, it is not clear whether similar factors are correlated with infestation with pubic lice (Phthirus pubis). We examined the association of two measures of socioeconomic status with each condition in a random sample of 500 notifications of each condition in the Israel Defense Forces. Since head lice were predominantly reported in females, and pubic lice predominantly in males, the analyses for head lice were restricted to females (474 cases) and those for pubic lice to males (481 cases). A significant negative association was found between both the number of years of formal education and a measure of socioeconomic status with infestation with both head and pubic lice. These findings suggest that among adults, both types of infestation are more common in the lower socioeconomic groups, and this should be taken into account when designing public health campaigns to control these problems.

Adult↗

The ocular manifestations of sexually transmitted diseases.

The problem of ocular involvement in sexually transmitted diseases is encountered by ophthalmologists in everyday practice. This paper reviews the ocular manifestations of some of the more common sexually transmitted diseases including AIDS, syphilis, gonorrhea and infections caused by herpes simplex, Chlamydia trachomatis and Phthirus pubis. Current methods of diagnosis and treatment are discussed. Neonatal infections associated with sexually transmitted diseases are also reviewed.

Acquired Immunodeficiency Syndrome↗

Ectoparasites as sexually transmitted diseases.

Although Sarcoptes scabii and Phthirus pubis infestations in humans are not always associated with the presence of other sexually transmitted diseases, usually they are. Therefore, patients presenting with scabies or P. pubis should be routinely tested for various sexually transmitted diseases. These very uncomfortable infestations are easily curable with proper therapy. Lindane 1% preparations effectively exterminate both vermin. We have not seen any resistant strains. Especially with P. pubis, all household contacts should be treated to avoid reinfestation.

Animals↗

Abnormal distribution of the histocompatibility antigens (HLA) in lousy patients.

The histocompatibility antigens have important functions in the development of the immune response, in the development of immunologic tolerance and in the resistance and susceptibility to diseases. In the present study, the frequency of the human leucocytic antigens (HLA) were studied in 31 lousy children with Pediculus h. capitis (head lice) and 14 adults with Phthirus pubis (pubic lice) to evaluate the immune response in their pathogenesis. The patients (children and adults) were parasite-free as indicated by urine, stool and blood analysis and clinical examination. A significant increase was found between HLA-A11 and, -B5 and lousy children with P. h. capitis and between HLA,-A11, -B5 and -B27 and lousy adults with P. pubis. The association between HLA antigens and parasitic infection was discussed.

Adult↗

The crab louse-review of physiology and study of anatomy as seen by the scanning electron microscope.

Effective control of a parasitic infestation is aided by a thorough understanding of the parasite and it interaction with the host. The external anatomy of Phthirus pubis and its egg were studied by scanning electron microscopy and the structures visualized were reviewed to determine their function. The pathophysiology of the insect-host interaction and current treatment recommendations were also reviewed.

Animals↗