A Rare Case of Blebharitis: Phthiriasis Palpebrarum

Abstract

A six-year-old male patient was admitted to our hospital due to itching and scalding crusts that persisted 10-15 days in both eyes. Upon biomicroscopic examination, 5-6 semi-translucent, yellowish brown living lice attached to the upper eyelashes and a large number of eggs were observed. Following application of pilocarpine hydrochloride (Pilomann 2%, Bausch-Lomb) and topical proparacaine hydrochloride (Alcaine 0.5%, Alcon), the paralyzed parasites and eggs were manually removed by pulling with forceps. The lice were identified as adult forms of pubic louse, Pthirus pubis, and its eggs. The patient was treated with pilocarpine hydrochloride, which was applied thrice a day combined with pure vaseline. One week later, no lice or eggs were seen on the eyelashes.

A clinical review and history of pubic lice

“…The eyelid needs careful examination with good lighting, possibly requiring a slit lamp. Case reports have suggested various treatments, including tea‐tree oil, physostigmine, pilocarpine and fluorescein ophthalmic drops; these seem to be used for occlusive purposes with no obvious pediculicidal properties 9,18,28,29 . Cryotherapy, argon lasers or botox have been used in difficult cases to structurally damage the lice and facilitate removal 18–19,29 .…”

“…However, these are invasive and expensive options. Recommended treatment options are summarized in Table 2 6,13,14,16,17,28,29 …”

“… a Developed from case reports/series as no clear guidelines on management currently exist 6,13,14,16,17,28,29 …”

Investigation of Morphological Characteristics of Pubic lice (Pthirus pubis, Linnaeus, 1758)

“…Eggs that stick to the hairs are called nits. Female pubic lice leave their eggs after providing nutrients to them (Altınsoy et al, 2018;Roberts and Janovy, 2009).…”

“…In inguinal lice, the infectious stage is observed in adults and can be transmitted from person to person, mostly through sexual contact, less through clothing, contaminated toilets, and beds (Anderson and Chaney 2009). In different studies, it has been shown that pubic lice can be transmitted between family members, not only between spouses but also especially young children who are in close contact with their parents, by settling on the eyelids and clinically leading to pitriasis palpebrarum (Veraldi et al, 2009;Altınsoy et al, 2018). In the study, the wife and children of the clinical case that we evaluated did not have a history of the disease.…”