Case Report
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Nov 26, 2021; 9(33): 10323-10327
Published online Nov 26, 2021. doi: 10.12998/wjcc.v9.i33.10323
Crab lice infestation in unilateral eyelashes and adjacent eyelids: A case report
Wei Tang, Qian-Qian Li
Wei Tang, Department of Ophthalmology, The Affiliated Wuxi No. 2 People’s Hospital of Nanjing Medical University, Affiliated Wuxi Clinical College of Nantong University, Wuxi 214000, Jiangsu Province, China
Qian-Qian Li, Intensive Care Unit, The Affiliated Wuxi No. 2 People’s Hospital of Nanjing Medical University, Affiliated Wuxi Clinical College of Nantong University, Wuxi 214000, Jiangsu Province, China
Author contributions: Tang W designed and drafted the manuscript; Li QQ provided care for the patient, generated the figures, and revised the manuscript for important intellectual content; both authors read and approved the final version of the manuscript.
Supported by the Youth Program of Wuxi No. 2 People’s Hospital, No. YZQN16.
Informed consent statement: Consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare having no conflicts of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Qian-Qian Li, MD, Chief Physician, Intensive Care Unit, The Affiliated Wuxi No. 2 People’s Hospital of Nanjing Medical University, Affiliated Wuxi Clinical College of Nantong University, No. 68 Zhongshan Road, Liangxi District, Wuxi 214000, Jiangsu Province, China. lqqeve@163.com
Received: July 6, 2021
Peer-review started: July 6, 2021
First decision: July 26, 2021
Revised: August 1, 2021
Accepted: September 10, 2021
Article in press: September 10, 2021
Published online: November 26, 2021
Processing time: 138 Days and 21.3 Hours
Abstract
BACKGROUND

Crab lice (Phthirus pubis) infestation can occur at any age, to either males or females, and across all regions of the world. However, cases involving the eyelashes and adjacent eyelids (phthiriasis palpebrarum) are rare. Usually occurring as a sexually transmitted disease, crab lice can be spread by poor hygiene or in a dirty environment through direct contact with contaminated skin (hands) or textiles (towels and clothing).

CASE SUMMARY

A 50-year-old woman presented to our hospital with a 2-wk history of chronic eyelid pain and itching in the right eye, which exacerbated in the evening hours and which had not resolved following a 1-wk course of antibiotics and corticosteroid ointments (for blepharitis diagnosis from another hospital). A careful ophthalmic slit-lamp and light microscope examination revealed multiple crab lice and nits on the right upper eyelashes; the right and left lower eyelashes were normal. Following the new diagnosis of phthiriasis palpebrarum, the patient was treated by removing the affected eyelashes, the crab lice, and their nits completely. Additionally, the eyelids were washed once with povidone-iodine. A follow-up examination at 2 wk later showed complete resolution of symptoms and no evidence of re-infection.

CONCLUSION

This case emphasizes the importance of correct diagnosis and complete removal of eyelashes, crab lice and nits to cure phthiriasis palpebrarum.

Keywords: Crab lice; Infestation; Unilateral eyelashes; Phthiriasis palpebrarum; Treatment; Case report

Core Tip: Crab lice (Phthirus pubis) infestation of the eyelids and lashes (phthiriasis palpebrarum), despite manifesting eyelid pain and itching, is easy to miss, even for ophthalmologists, as the lice and nits are translucent. For the case presented here, a light microscope revealed the features of crab lice and nits in unilateral eyelashes and adjacent eyelids. Complete removal of the affected eyelashes, by trimming or plucking, followed by a single povidone-iodine rinse appears to be a simple, safe and effective method of treatment.