How would you treat a toddler who has pubic lice in her eyelashes? Also, would you dare to explore how the toddler became infested?
—Frank S. Horner, MD, Ocala, Fla.
Pubic or crab lice (Phthirus pubis) are transmitted during sexual contact in adults. In children, the lice sometimes infest the eyelashes and, uncommonly, the scalp. These lice can move about in the dark and migrate from one hairy area to another. Infants and children with eyelash involvement are usually infested by direct passage of the lice from the axillary or chest hair of the parent or other infested contacts. Several treatments have been reported, including anticholinesterase agents, epilation, lindane, cryotherapy, manual removal of the lice, ivermectin, argon laser, yellow mercuric oxide, malathion, and cutting the lashes at the base.
—Jeffrey Weinberg, MD (115-14)