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Phthirus pubis Infestation of the Eyelashes-Reply

Melvin H. Kirschner, MD, MPH
JAMA. 1983;250(1):32-33. doi:10.1001/jama.1983.03340010018013.
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In Reply.—  When I wrote my original letter regarding P pubis of the eyelashes last year, it was not my purpose to get involved in a discussion of age and sex distribution. Rather, it was to alert the physician to the fact that an unresponsive "blepharitis" or "conjunctivitis" could prove to be P pubis infestation of the eyelashes when examined with a magnifying lens. In my clinical experience, eyelash infestation occurs in adults as well as children, and this seems to be confirmed by case reports in the literature.Goldman1 reported six juvenile cases of infestation of both eyelashes and scalp. He noted that "involvement of the scalp should be suspected in children with infestation of the cilia." Four cases reported by Couch et al2 all involved adults.Regarding body distribution, Orkin3 suggested that "predilection of the 'crabs' for pubic hairs is probably related to hair density... the

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