Combined treatment modality including topical 20% fluorescein dye in the management of phthiriasis palpebrarum � A case series

Purpose: To study the clinical presentations and outcomes of phthiriasis palpebrarum (PP) managed with combined treatment modality comprising of 20% fluorescein dye, mechanical removal of the ectoparasites, and topical application of antibiotic eye ointment with paraffin base. Methods: This is a prospective interventional noncomparative hospital?based series of 13 patients of PP. All the patients underwent local application of 20% fluorescein dye over the eyelashes and eyebrows of both the eyes followed by the mechanical removal of all the ectoparasites and trimming of the eyelashes from the base followed by application of ophthalmic ointment. Results: Mean age of the patients was 28 � 22 years (range 3� Years). Out of the total of 13 patients, 11 patients (85%) were having bilateral involvement. The mean duration of symptoms in 11 patients (rest 2 were accidental findings) was 4 � 3 weeks (range 1� weeks). Three patients (23%) had a history of sexual contact with possible parasite?infested partners. Four patients (31%) had additional parasites in the pubic area or torso. All the patients were completely parasite free at the end of 1 month. There was no infestation of the treating medical personnel from the patient. The average follow?up was 8 � 5 months (range 3� months). Conclusion: Itching and irritation of the eyes were the most common presentations of PP. Combined treatment modality comprising of 20% fluorescein dye, mechanical removal of ectoparasites, and topical application of antibiotic eye ointment with paraffin base is effective in the management of PP

Combined treatment modality for phthiriasis palpebrarum

Phthiriasis palpebrarum (PP) is the infestation of eyelids caused by the ectoparasite Phthirus pubis, frequently misdiagnosed as allergic conjunctivitis, blepharitis or dermatitis. There is no standard treatment of choice although various treatment modalities have been described. A 6-year-old male child with PP was successfully treated with local application of 20% fluorescein solution over the eyelashes and eyebrows of both the eyes, followed by the mechanical removal of all parasites and trimming of the eyelashes from the base and application of ophthalmic ointment.

Phthiriasis palpebrarum presenting as anterior blepharitis

In humans, Pthirus pubis or crab louse usually infests hair of pubic region. Phthiriasis palpebrarum (infestation of the eyelashes and eyelids) is not as rare as is reported in literature, especially in low socioeconomic communities. It is possible that the disease is being perhaps missed due to its clinical similarity with anterior blepharitis. The nits and adult lice adhering to the eyelashes can easily be overlooked. This study presents five cases of phthiriasis palpebrarum, coming from the same locality and socioeconomic background, presenting with itching, hyperemia of lids, and excoriation of skin. Two patients were misdiagnosed elsewhere. All were successfully treated. The presence of P. pubis reflects the low level of health and hygiene of that stratum of the society. Higher prevalence could be related to rapid urbanization, overcrowding, and extreme poverty. The health-care providers and policymakers should give more merit to this not so uncommon disease having high morbidity.

Ectoparasite Presenting with Common Eye Condition.

Ectoparasites are the parasites that live primarily on the surface of the host. We report a case of a 40-year-old woman who phthiriasis palpebrarum, presented with signs and symptoms of a common eye condition blephero conjunctivitis. She was diagnosed to have phthiriasis palpebrarum. The infestation by this organism is regarded as a marker for other sexuallytransmitted disease (STD) infections like human immunodeficiency virus (HIV), syphilis, gonorrhea, chlamydia, herpes genitalis and trichomonas.

Case of Phthiriasis palpebrarum with blepheroconjunctivitis.

A 70-year-old woman came to ophthalmology outpatient department with complaints of repeated episodes of itching, redness and watering in both eyes of 3 months duration. She was treated with antibiotics elsewhere but had no improvement. Slit lamp examination showed lice and nits anchored to the eyelashes. Light microscopic examination of the matted eye lashes and crusts further helped in identification of the ectoparasites as Phthirus pubis (Pubic louse or Crab louse) with typical morphology.

A Case of Phthiriasis Palpebrarum Treated with Tea Tree Oil in a Child

PURPOSE: The authors of the present study report a case of phthiriasis palpebrarum treated with petrolatum ointment and tea tree oil in a 12-month-old boy. CASE SUMMARY: A bluish-gray macule and blood clots were found on the central portion of the upper eyelid of a boy who had rubbed his eyelid vigorously 1 week prior. Several 0.5 mm sized brownish-gray nits and 1.6 mm sized lice on the eyelashes were visible and was diagnosed with phthiriasis palpebrarum after light microscopic examination. The nits and lice were gently removed mechanically with the help of a white petrolatum ointment (Vaseline) and the eyelashes were cleaned with 50% tea tree oil. Nits and lice were successfully eradicated without recurrence 10 days after daily treatment with petrolatum ointment and 10% tea tree oil eyelash cleansing.

Mechanical Treatment of Phthiriasis Palpebrarum

Phthiriasis palpebrarum is a rare disease in which crab lice infest the eyelashes. It can cause pruritic lid margins or unusual blepharoconjunctivitis and is difficult to diagnose and treat. We diagnosed and managed a case of phthiriasis palpebrarum in both upper eyelids, accompanied by nits, on the scalp of a 6 year-old female child. We removed the eyelashes, including lice and nits, by pulling with fine forceps without sedation. On the second month after treatment, all lice and nits were eradicated without recurrence and the eyelashes grew back. In conclusion, phthiriasis palpebrarum can be diagnosed by close examination of the eyelashes and eyelid margins with slit lamp and can be managed mechanically.

A Case of Phthiriasis Palpebrarum in Children

The majority of the crab louse is found in pubic hairs, but some of them will colonize axillary hairs, eyelashes, eyebrows and occasionally scalp hairs. In children crab louse may colonize the eyelashes and scalp hairs. The authors found a crab louse, Phthirus pubis and their nits on the eyelashes and scalp hiars of 25-months-old female who complained of foreign body and itching sensation of her right upper lid. Treatment is accomplished by careful mechanical removal of the louse and nits followed by the epilation and application of antibiotic eyedrops or ointments. We report a case of Phthiriasis palpebrarum in children.

A Case of Phthiriasis Palpebrarum

Phthiriasis has been usually known as a sexually-transmitted disease. The majority of these cases are found in the hair of the genital lesion, however, infestation of the eyelashed may occur. Eyeld involvement frequently causes blepharitis or conjunctivitis. The authors found a crab louse, Phthirus pubis and their nits on the eyelashes of 22-year-old female who complained foreign body and itching sensation of her right upper lid. Treatment is accomplished by careful mechanical removal of the louse and nits followed by the epilation and alllication of antibiotic eyedrops. We report a case of Phthiriasis palpebrarum with a review of the literatures.

Phthiriasis palpebrarum.

Phthiriasis palpebrarum by crab louse or Phthirus pubis involving the eyelids is rarely found in adults. This paper reports three patients who came to Songklanagarind Hospital with the symptoms of itching and bleharitis. The treatment for these three cases of Phthiriasis palpebrarum were successful with no relapse.