Crab Louse infestation of eyelashes

Abstract

Purpose: To present clinical features and management of ten patients of crab louse infestation of eyelashes Methods: Present study includes ten cases of crab louse infestation of eyelashes seen during last few years in eye OPD of Services Hospital & Jinnah Hospital Lahore. Patients visiting eye out-patients department who were reported to have crab louse infestation of eyelashes were examined in detail including systemic examination. Infested parts of the body were photographed as well. The adult patients were asked about similar problem in their sexual partners and the parents of children were inquired similarly. All patients were treated with adequate washing of eyelashes and other involved parts with soap and water and application of any ophthalmic preparation having petroleum base e.g. Polyfax eye ointment in the conjunctival sac and eyelashes and anti-lice dermal preparation e.g. Lotrix (Permethrin) skin preparation to other parts. All patients were followed for a period of three months performing examination of eyelashes with slitlamp and systemic examination every two weeks. Results: Seven out of ten patien ts were adults (70%), five males and two females, and remaining three patients were children (30%). Forty percent of patients (4/10 patients) had related systemic lesions, including blue gray macules (Maculae caeruleae) and the bullous lesions. In addition to systemic dermatological manifestations, ocular symptoms included deposits in the roots of eyelashes, irritation or feeling of some thing moving in lid margins, mild lacrimation and redness. Ocular examination revealed multiple lice anchoring themselves in the roots of eyelashes sucking blood, along with hundreds of nits cemented with eyelashes. There was a mild conjunctival congestion. Removal of lice resulted in formation of small ulcers of margin of lid. Adequate washing with soap and water, followed by application of Polyfax eye ointment for two to three weeks, resulted in complete cure of the palpebral disease. Conclusion: This study emphasizes the significance of an infrequently seen clinical condition of crab louse infestation of eyelashes, not only as a venereal disease expecting much higher number of infections but also as an important cause of refractory cases of chronic irritation of eyes with blepharitis. Careful examination of eyelids with slitlamp microscope may establish the diagnosis. All the sexual partners should be treated simultaneously. Other parts of the body having less dense population of hair should be examined and adequate measures should be taken for the management, including application of anti-lice dermal ointment e.g. Lotrix (Permethrin) skin ointment.