Ciliary phthiriasis: Dermoscopic diagnosis

Phthiriasis palpebrarum (lice infestation of eyelid) is a rarely reported disorder. It may present as blepharoconjunctivitis, and is therefore often neglected. We present a 36 year-old female who suffered itching and irritation at eyelids. A careful examination of the eyelids objectified blackish granules of cilia. Dermoscopic examination revealed the presence of nits attached to the eyelashes with tiny brownish punctuation found on the skin, which they could easily recognize as adult lice that were mobilized around the eyelids. She was successfully treated with oral ivermectin. After clinical and dermoscopical control, no more lice or nits were present in the patient. This report emphasizes the importance of the correct diagnosis and management of this disease, and the interest of dermoscopy in the diagnosis and treatment evaluation of phthiriasis palpebrarum.