Phthirus Pubis Research Articles

Phthiriasis palpebrarum: A case report and brief review of literature

Phthiriasis palpebrarum (PP) is a rare infection of the eyelid caused by pubic lice, often confused with other causes of blepharoconjunctivitis. In this study, we report a case of a 3-year-old girl with PP who was treated for conjunctivitis in the past month due to itching and eye irritation in the right eye. Slit-lamp examination revealed dense activity and translucent lice and eggs. For treatment, the lice were first mechanically cleaned, eyelashes were removed from the base, eggs and lice were removed from the eyes, and then tobramycin eye drops was administered to prevent conjunctivitis. A re-examination done 1 month later showed no recurrence.

Clinical Characteristics and Prognosis of Pediatric Phthirus pubis Coinfestation of the Eyelashes and Scalp Hairs.

Phthirus pubis infestation is a highly infectious parasitic disease, affecting 1.3-4.6% of people globally. However, the coinfestation of P. pubis on the eyelashes and scalp hairs in children is uncommon, and the clinical characteristics and prognosis have not been fully studied. In this retrospective study, we report five pediatric patients diagnosed with eyelash and scalp coinfestation of P. pubis. The samples were obtained after treatment and sent for pathological examination. The demographic and clinical characteristics of the study participants were analyzed in detail. Numerous lice and nits were detectable on the eyelashes and scalp hairs in all enrolled patients. The ages ranged from 2 to 5 years. The duration of onset ranged from 3 to 10 days. The common clinical presentations were itching (100%) and conjunctivitis (60%). Treatment included eyelash and scalp hair trimming to the root (100%) and mechanical removal of the parasites (100%), in addition to topical tobramycin eye ointment (100%) and phenothrin shampoo (80%). Symptoms resolved by a 1-week follow-up. Pediatric P. pubis coinfestation mainly occurs on the eyelashes and temporal scalp in females, and sometimes contact tracing fails to identify the source. Phthirus pubis infestation of eyelashes can be misdiagnosed as blepharoconjunctivitis. Sexually transmitted diseases should be ruled out for patients with P. pubis infestation. Untreated or persistent cases may lead to several serious infections.

Misleading Presentation of Unilateral Phthiriasis Palpebrarum in a 2-Year-Old Boy.

A 2-year-old boy with recently treated head lice presented with worsening right eyelid pruritus, irritation, and bleeding that was presumed to be a reinfection of head lice. Clinical examination revealed ectoparasites along the superior eyelid margin that were later identified as Phthirus pubis, or pubic lice. Treatment and management strategies are discussed. [J Pediatr Ophthalmol Strabismus. 2023;60(5):e55-e58.].

Phthiriasis palpebrarum.

A 77-year-old woman presented to our dermatology clinic with itching on her scalp. We diagnosed scalp pediculosis caused by pubic lice and treated the patient with 5% permethrin lotion for 3 weeks. Her scalp symptoms resolved but 2 weeks into her treatment, she developed eyelid pruritus and she

Phytotherapy for Sexually Transmitted Infections In ThabaNchu, Free State Province, South Africa

Medicinal plants have been prescribed by traditional healers for the treatment of Sexually Transmitted Infections (STI’s) for years. This study documents therapeutic plants used against STI’s in Thaba ‘Nchu, South Africa. Information was gathered through semi-structured interviews with traditional medical practitioners between March and December 2017. Information on medicinal plants, their local names, and their uses against STI’s was gathered. The use value (UV) of the plant species, frequency of citation (FC) and the informant consensus factor (ICF) were calculated for the plants and STIs included in the study. Plants were used to treat infections such Herpes zoster (ICF=0.4) as gonorrhoea (ICF=0.11), vaginosis (ICF=0.2), symptoms of HIV/AIDS (ICF=0.1) and pubic lice (ICF=0.1). A total of 35 plant species were identified for the treatment of STIs. Most medicinal plants in the study area came from the families Asteraceae (21%), Fabaceae (17%), Solanaceae (13%) and Hyacinthaceae (13%). Bulbinenarcissifolia, Pentanisiaprunelloides, Hypoxishemerocallidea, Scabiosa columbaria, Xysmalobiumundulatum Rumex lanceolatus, Eucomisautumnalis, Dicomaanomalaand Salvia runcinatawere frequently used. The preferred method for preparation of remedies were decoctions made from the roots (72%), whole plant (17%), leaves (7%), fruits (2%) and bark (2%) which were consumed orally.This study contributes to the documentation of plants used for STIs to conserve the information for future generations. A selection from the most frequently mentioned plants for treatment of STI’s may be used for further phytopharmacological investigations and subsequently be used for the development of new antimicrobial agents for global use and for the socioeconomic development of local communities.

A rare case of bilateral Phthiriasis palpebrarum with crab louse

Phthiriasis palpebrarum is a rare cause of blepharitis in which Pthirus pubis infests the eyelashes. We report a case of bilateral Phthiriasis palpebrarum with crab louse. A 48-year-old woman presented with severe itching in both eyes for 4 days. Careful slit-lamp examination revealed multiple motile lice and nits in the eyelashes of both eyes with mild conjunctival hyperemia. Treatment was started by manually removing all the adult lice and eyelashes where nits were seen adhering and by the application of petrolatum jelly. After 2 weeks, she was symptomatically better with no louse or nit on her eyelashes on ocular examination.

Dermoscopy of pediculosis pubis in an octogenarian man

Dermoscopy of pediculosis pubis in an octogenarian man

Don't Be a Nit Wit; Know Your Lousy Companions!

Lice have been a burden on humans since antiquity. The species implicated in human infestations, the head louse (Pediculus humanus capitis), body louse (Pediculus humanus humanus), and pubic louse (Pthirus pubis), are very well adapted to the human host and are readily transmissible between and among individuals. In addition to dermal reactions and social stigmas associated with louse infestations, the body lice are of additional medical and public health concern in the spreading of bacterial agents associated with louse-borne relapsing fever, epidemic typhus, and trench fever. In the United States, pthiriasis, caused by P. pubis, is classified as a sexually transmitted infection. In this review, we provide an update on the taxonomy, epidemiology, biology, evolution, clinical importance, treatment and control, diagnosis, and reporting of parasitic human lice.

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

Pubic lice (Pthirus pubis) are obligate, permanent ectoparasites of humans, entirely dependent upon their vertebrate hosts for survival. Pubic lice have a very simplified body form as a result of their parasitic characteristics, being wingless and dorsoventrally flattened. In the study, the pubic lice taken from a male patient were examined morphologically in detail and their taxonomic characteristics were presented. The lice specimens were examined for morphological and taxonomic characteristics under a light microscope. The identification of the Pthirus pubis species was made by determining the height, anatomical body parts, dorsal and ventral morphological details of the adult male and female two pubic lice. Examined adult pubic lice were light cream-colored, 1-2 mm in length, and their anatomical structures included three pairs of legs, two prominent antennae, and parts of the thorax and abdomen in a combined structure. Pthirus pubis causes pediculosis pubis disease in humans. The disease can be sexually transmitted to humans. Pthirus pubis is spread primarily through person-to-person sexual contact. Pubic louse is a major public health problem that can be contagious among humans, and it has great importance to know their morphological characters to diagnose this ectoparasite and distinguish it from other insects.

Combined treatment modality including topical 20% fluorescein dye in the management of phthiriasis palpebrarum - A case series.

Purpose:To study the clinical presentations and outcomes of phthiriasis palpebrarum (PP) managed with combined treatment modality comprising of 20% fluorescein dye, mechanical removal of the ectoparasites, and topical application of antibiotic eye ointment with paraffin base.Methods:This is a prospective interventional noncomparative hospital-based series of 13 patients of PP. All the patients underwent local application of 20% fluorescein dye over the eyelashes and eyebrows of both the eyes followed by the mechanical removal of all the ectoparasites and trimming of the eyelashes from the base followed by application of ophthalmic ointment.Results:Mean age of the patients was 28 ± 22 years (range 3–60 Years). Out of the total of 13 patients, 11 patients (85%) were having bilateral involvement. The mean duration of symptoms in 11 patients (rest 2 were accidental findings) was 4 ± 3 weeks (range 1–10 weeks). Three patients (23%) had a history of sexual contact with possible parasite-infested partners. Four patients (31%) had additional parasites in the pubic area or torso. All the patients were completely parasite free at the end of 1 month. There was no infestation of the treating medical personnel from the patient. The average follow-up was 8 ± 5 months (range 3–21 months)Conclusion:Itching and irritation of the eyes were the most common presentations of PP. Combined treatment modality comprising of 20% fluorescein dye, mechanical removal of ectoparasites, and topical application of antibiotic eye ointment with paraffin base is effective in the management of PP.

Prevalence of Pediculus humunus capitis, Pediculus humanuscorporis, and Pthirus pubis in Al-Kut, Iraq.

Lice infestations or pediculosis occurs throughout the world and is caused by Pediculus humunus capitis (head louse), Pediculus humanuscorporis (body louse), and Pthirus pubis (crab louse). This study was conducted within March-October 2020 and aimed to investigate the presence of human lice among 1,632 individuals from 225 families living at different economic and social levels in AL-Kut city, Iraq, and its suburbs (urban, rural, and slum areas). Data collection was performed on volunteer families by completing survey forms and visual examinations. The families were divided by the number of members into 10-15, 7-9, 4-6, and 3-2 persons, for which, the infestation rates were estimated at 24.2%, 21.4%, 12.5%, and 8.6%, respectively. Moreover, in this study, urban, rural, and slum areas were infected at 11.5%, 33.6%, and 21.6 %, respectively. The infestation appeared in all ages, and the higher and lowest rates were obtained for the age ranges of 3-17 and 18-40 years old (79.04% and 20.9%), respectively. Based on the results, the rates of infestation were 21.8% and 13.3% in females and males, respectively. The findings of this study showed that the infection rate of Pediculus humanus corporis among the subjects aged 4-24 years old was 11.0% and that of Pthirus pubis was 3.0% in the cases aging 14-32 years old. Due to the high infestation with ectoparasites in these areas and large families, it is highly important to create conditions for health and provide information to control and prevent infection.

Bug alert! A case report and review of literature on bilateral phthiriasis palpebrarum

We report a case of phthiriasis palpebrarum in an immunocompetent individual along with the review of the literature. A 61-year-old woman presented with a 2-month history of itching and burning sensation in both eyes. Examination revealed lice and nits anchored to the eyelashes with a mild follicular conjunctival reaction and no evidence of discharge. The patient recovered fully within 2 weeks after manual removal of the lice and crusts along with topical antibiotic ointment and oral ivermectin, with no evidence of lice or nits on follow-up. This study suggests that patients presenting with itching of the eyelids and other asthenopic symptoms should be carefully examined by slit-lamp examination, to not miss out on unusual diagnoses such as found in this case.

What's Bugging You: A Closer Look at the Crab Louse.

What's Bugging You: A Closer Look at the Crab Louse.

AAUS guidelines 2021 revision sexually transmitted infection (STIs) diagnostic strategy for STI

AAUS guidelines 2021 revision sexually transmitted infection (STIs) diagnostic strategy for STI

A Case for Lice

Hair, body, and pubic lice plagued past populations just as much as they do today. These types of lice require a human host to survive, and they thrive in contact-rich and sedentary groups. Lice, especially head lice, are difficult to get rid of without constant attention, which makes them suita­ble as proxy data for studying human behaviours of the past. By studying lice in the archaeological record, archaeologists can further understand the human experience. For instance, lice, eggs, and delousing combs have been found with human remains in the archaeological record and have been collected, cleaned, and studied, to better understand the lives of past humans. Additionally, body lice can spread diseases and can indicate stressors people endured during life and prior to death, such as overcrowding and illness. Lice studies have also been used to evaluate human cultural behaviours, how people interacted with others, how people lived with lice (if and where delousing activities took place), and how people dealt with ongoing infestations in the past. This article serves to provide a comprehensive overview of the archaeological analysis of lice, the important insights that lice can bring to current understanding of the past, the importance of proper collection, clean­ing, and studying of lice, and the ways in which lice in the archaeological record have informed archaeologists about the past.

A clinical review and history of pubic lice.

The ectoparasite Pthirus pubis (PtP), commonly known as the crab or pubic louse, has plagued primates from prehistoric apes to Homo sapiens. We combed the literature from antiquity to the present day, reviewing the pubic louse's origins, its evolution with mankind, and its presentation and management. MEDLINE and EMBASE provided the greatest yield of literature compared with other databases. Estimates for PtP incidence range from 0.3% to 4.6% and for prevalence around 2% in adults. War, disasters and overcrowding support lice transmission, but modern pubic hair grooming has reduced the incidence of PtP in recent years. PtP, is usually found on pubic hair, but may infest scalp and body hair, eyebrows and eyelashes. Reports suggest the possibility of PtP as a vector for Bartonella spp. and Acinetobacter spp., which require further study. Transmission of PtP is via close contact, so sexual abuse and concomitant sexually transmitted infections should be considered. Symptoms and signs of infestation include pruritus, red papules and rust/brown deposits from feeding or faecal matter. Visualization of live lice confirms the diagnosis. Traditional treatments include hand-picking and combing, but in modern times pediculicidal products may generate faster resolution. Permethrin or pyrethrins are the first-line recommendations. Resistance to pediculicides is common with head lice and is presumed likely with PtP, although data are lacking. Pseudoresistance occurs as a result of poor compliance, incorrect or ineffective dosing, and reinfestation. In true resistance, a different pediculicide class should be used, e.g. second-line agents such as phenothrin, malathion or ivermectin. Lice have existed long before humans and given their adaptability, despite habitat challenges from fashion trends in body hair removal, are likely to continue to survive.

Sexually Transmitted Infections in U.S. Military Women: A Scoping Review 2000–2018

High rates of sexually transmitted infections (STIs) have been documented among U.S. military servicemembers. The purpose of this scoping review is to evaluate the literature to determine what is known about the risk factors, preventive measures, and health outcomes regarding STIs among active duty servicewomen. A search of six bibliographic databases and the grey literature identified articles published from January 1, 2000, to December 31, 2018. A two-level review process was used to evaluate the inclusion of articles. Fifty-six articles were included. The majority of studies (n=47) were descriptive (95%). The primary STIs of focus were chlamydia (66%) and gonorrhea (38%), with a lesser focus on herpes simplex virus 1 and 2 (17%) and syphilis (11%). There were no studies on chancroid or pubic lice. Chlamydia and gonorrhea were highly prevalent. Age, race, and gender were nonmodifiable risk factors, whereas behaviors, beliefs, socioeconomic level, marital status, and concomitant or repeat infections were modifiable risk factors. Educational programs and studies evaluating efficacious STI prevention methods were lacking. STI diagnoses occurred in servicewomen at their home stations as well as in deployed settings. STIs remain an ongoing public health challenge with insufficient research to guide military and health care leaders. Future research should focus on prospective designs that leverage identified risk factors and at-risk populations where the most impact can be made to promote reproductive health.

BI15: Widespread pediculosis pubis infestation associated with natalizumab

BI15: Widespread pediculosis pubis infestation associated with natalizumab

Extragenital Phthiriasis: Diagnosis Made Simple by Dermoscopy.

A 21-year-old, otherwise healthy, man presented with a 2-week history of black spots on his lower extremities and buttocks associated with pruritus. On clinical examination, black structures within dense hairs and bilateral inguinal lymphadenopathy were present. Handheld dermoscopy (magnification ×10, Dermlite D4; 3Gen, Juan Capistrano, CA) showed multiple living crab-shaped organisms, consistent with Phthirus pubis, as well as nits attached to the hair shafts; neither could be clearly identified by the naked eye only (Figs. 1, 2; Video 1 [https://links.lww.com/OLQ/A659]). No insects were present in previously shaved genital area. The screening for other sexually transmitted diseases was negative. The patient was successfully treated with 5% topical permethrin and hair removal.Figure 1: Phthirus pubis. aAdult parasite grasping hairs with claws, visible blood within the digestive system. bAdult parasite sucking blood with mouth inserted into the skin.Figure 2: Phthirus pubis. aAdult parasite. bNit. cMacula cerulea.A study by Truesdale et al.1 reported that weighted percentages of pubic hair grooming in women and men in the United States equal 85.3% and 66.5%, respectively. Because of increased pubic hair removal, extragenital P. pubis infestation in hair-bearing areas such as eyebrows, eyelashes, mustache, beard, axillae, and trunk may be more commonly observed.2,3 Because P. pubis is smaller, lighter, nearly transparent, and not as mobile as other lice, the diagnosis of human phthiriasis by the naked eye only may be more difficult.4 There are a few reports on the usability of dermoscopy (entomodermoscopy) in diagnosing of human pthiriasis. This method may be performed both ex vivo and in vivo.2 To our knowledge, this is the first description of the usability of dermoscopy in vivo in extragenital pthiriasis of the lower legs and buttocks. Dermoscopy in vivo enables visualization of the life cycle of P. pubis with empty nits (with flattened ends), nits containing nymphs (brown and ovoid), nymphs, and adult organisms.5 Handheld dermoscopy is a simple and quick method in diagnosing extragenital phthiriasis.

First case of Phthirus pubis and Demodex co-infestation of the eyelids: a case report

BackgroundPhthirus pubis is an obligate parasite of human beings. Demodex spp. is a much more common parasite of human beings. However, P. pubis infestation accompanied by Demodex mite infestation in eye has not been reported.Case presentationWe report the first case of Phthirus pubis and Demodex co-infestation on a 48-years-old woman. She presented to the hospital with itching and burning at her right eye for 2 weeks. Slit lamp examination revealed multiple nits and adults of P. pubis anchored to both upper and lower eyelashes. Eyelashes were trimmed, moxifloxacin eye ointment and fluorometholone eye drops were initiated daily. However, itching didn’t improve after 2 weeks of treatment. Light microscopy examination of eyelashes revealed infestation with Demodex. The patient was treated with lid scrubs with 25% tea tree oil daily for 4 weeks and was completely cured.ConclusionOur report shows the importance of an early and comprehensive diagnosis, because both phthiriasis palpebrarum and demodicosis can be confused with blepharitis.