Persistent itching of the eyelids and scalp

Awoman inhermid 50s presentedwith amonth long history of persistent itching in both eyelids. She had received adiagnosis of blepharitis and conjunctivitis, and treatment with topical antibiotic and corticosteroid therapy, but she had seen no improvement in her symptoms. On slit lamp examination, the right eye conjunctiva was erythematous, and numerous lice and nits (eggs) were seen attached to the base and shaft of the eyelashes (fig 1). Lice and nits were also visible on the forehead and right temporal scalp, under operating microscopy. On light microscopy, the parasites were seen to be wingless, crab-like lice with a distinct head, a pair of slim weak anterior legs, and twopairs of thick strongposterior legs. Thenits firmly adhered to the eyelashes. Examination of the eyebrows, occipital region, nape, upper back, and axillae hairs was unremarkable.

一名50多岁的女性因双眼睑持续瘙痒1个月前来就诊。她曾被诊断为睑缘炎和结膜炎，并接受了局部抗生素和糖皮质激素治疗，但症状未见改善。在裂隙灯检查中，右眼结膜充血，在睫毛根部和睫毛干上可见大量虱子和虱卵（图1）。在手术显微镜下，在前额和右侧颞部头皮上也可见虱子和虱卵。在光学显微镜下，可见这些寄生虫为无翅、蟹状虱子，有明显的头部、一对纤细无力的前腿和两对粗壮有力的后腿。虱卵紧紧附着在睫毛上。对眉毛、枕部、颈背、上背部和腋窝毛发的检查无异常。