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Phthiriasis Palpebrarum

Purpose: To share vivid experiences of encountering Phthiriasis palpebrarum in the clinic by recently developed high-resolution digital slit lamp biomicroscopic images. To illustrate various facets of Phthirus pubis by highly magnified light microscopic images of nit and adult stage. To provide recent advances on treatment. Therefore, to improve diagnosis and treatment of Phthiriasis palpebrarum. Case summary: The authors found crab louses, Phthiriasis pubis and their nits on the eyelashes of 64 years old male patient who had been suffering from brownish discharge, foreign body sensation, and itching sensation of his both upper lids. By forceps, louses and their nits were carefully removed manually and all the infested eyelashes were epilated. Without any prescription of eye drops or medication, louses were completely eradicated and the patient were relieved from the symptoms. We report this case of Phthiriasis palpebrum with a review of the literature. Conclusions: Phthiriasis palpebrum is occasionally confused with common blepharitis. Careful examination by prolonged observation with a slit lamp is suggested to avoid misdiagnosis. If cooperation of the patient is guaranteed, mechanical removal of infested by forceps is the most effective treatment option for Phthiriasis palpebrarum.