Phthiriasis palpebrarum – A familiar pathogen at an unfamiliar site

A 53-year-old woman presented with history of itching in both eyelids. Slit-lamp examination revealed multiple translucent oval nits anchored to eyelashes [Fig. 1a] and 10–14 mobile adult lice in lid margins [Fig. 1b]. A diagnosis of phthiriasis palpebrarum was made, and curative treatment involved mechanical removal of the lice [Fig. 1c and https://links.lww.com/IJOG/A46]. The collected lice were subjected to high-magnification light microscope examination, which revealed 1–2 mm flat louse with stout and clawed second and third pair of legs, identified as Phthirus pubis, commonly known as crab louse [Fig. 1d].Figure 1: (a) Multiple translucent oval nits of Phthirus pubis (crab louse) anchored to eyelashes. (b) Adult lice nagging in the lid margin. (c) Lice after removal and (d) on high-magnification light microscope examinationThe crab louse is a hematophagous ectoparasite commonly infesting the coarse pubic hairs, but other hair-bearing sites can also be involved.[1] It may be misdiagnosed as blepharitis, unless visualized with close inspection. Declaration of patient consent The authors certify that they have obtained all appropriate patient consent forms. In the form, the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.