Phtiriase ciliaire de l’enfant. Diagnostic et traitement

Abstract

Phtiriasis palperarum is an unusual cause of blepharitis. This ectoparasitic infestation of the lashes is more frequent in adult; a pubic attack is usually associated. It is however rare in children. The goal of our study is to bring back four observations of infantile phtiriasis palpebrarum. Four children presented themselves for palpebral itching and ocular redness. Slit lamp examination revealed evidence of small parasites attached to the proximal extreme of the eyelashes. A survey within the family was carried out and parasitological examination was realized. Parasitological examination had identified adult forms and nits of phtirus pubis. The bed linen was the way of contamination. Mechanical extraction of the parasite was tried but was very painful. Two patients were treated with a regimen of 1% yellow oxide of mercury ointment four times daily for 14 days, the two others was treated by Vaseline pomade because of a very important palpebral irritation. Evolution was favorable among all patients. We discuss in this work the ways of contamination of phtiriasis palpebrarum in children. In fact, eyelashes contamination in children is secondary to a contact with an adult carrier of a pubic phtiriasis. The transmission can be done following sexual maltreatments or by the means of infected clothing or bed linen. The diagnosis of phtiriasis palpebrarum is clinical confirmed by parasitological examination. Different therapeutic were proposed, the mechanical treatment must be carried out but it is seldom sufficient and it is often necessary to associate a chemical treatment (malathion to 1%, mercury oxide with 1%, fluorescein with 20%...) or physical treatment (cryotherapy, laser argon). Diagnosis of phtiriasis palpebrarum is easy and requires the detection of the source of contamination in order to prevent reinfestations.