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Images/Instrument in Dermatology/Dermatosurgery
2024
:4;
27
doi:
10.25259/CSDM_19_2024

Uncommon presentation: Pubic lice infesting beard in a patient with neurodegenerative disorder

Department of Dermatology, All India Institute of Medical Science Bilaspur, Himachal Pradesh, India
Department of Dermatology, PGIMER, Chandigarh, India
Corresponding author: Muthu Sendhil Kumaran, Department of Dermatology, PGIMER, Chandigarh, India. drsen_2000@yahoo.com
Licence
This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-Share Alike 4.0 License, which allows others to remix, transform, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.

How to cite this article: Daroach M, Kumaran M. Uncommon presentation: Pubic lice infesting beard in a patient with neurodegenerative disorder. CosmoDerma. 2024;4:27. doi: 10.25259/CSDM_19_2024

An 82-year-old male with a non-specific neurodegenerative disorder presented with mild irritation in his beard. During the clinical examination, blackish, stuck-on lesions were observed in the patient’s beard and chest, which could be easily scraped off [Figure 1a]. Dermoscopic examination revealed live lice clinging to the surrounding body hair confirming the diagnosis of crab lice infestation [Figure 1b]. The patient was treated with topical 1% permethrin lotion, two local applications a week apart.

Figure 1:
(a) Blackish stuck structures on the skin of the beard and multiple nits clinging to hair. (b) Dermoscopy (DermLite II Hybrid M Dermatoscope at ×10 magnification in polarized mode) shows crab louse clinging on to hair.

Phthirus pubis or crab louse is a tiny parasite measuring 1.25–2 mm in length. It has an oval body resembling a crab with a smaller head and three pairs of legs. This louse is typically found in apocrine gland-bearing areas such as the genital, perianal, and groin regions but can also infest less common areas such as the chest, axilla, mustache, and beard. Diagnosis is based on the identification of adult lice and nits (lice eggs) on hair. Entomodermoscopy can be used as a rapid diagnostic tool. On dermoscopy, Phthirus pubis appears light colored, has a smaller size (1•2 × 8 mm), and has slow motility as compared to the brown color, larger size, and quick motility of Pediculus humanus (human head and body lice). In addition, P. pubis appears such as pincers of a crab due to the thicker posterior pair of legs than the front pair giving it an appearance similar to the pincers of a crab.[1]

This case highlights the importance of prompt diagnosis and appropriate treatment for parasitic infestations such as crab lice, especially in individuals with compromised health or in vulnerable populations. It is crucial to follow the recommended treatment protocols and take measures to prevent further transmission.

Author’s contributions

Dr(s) Muthu Sendhil Kumaran and Manju Daroach had full access to all of the data in the study and took responsibility for the integrity of the data and the accuracy of the data analysis. Muthu Sendhil Kumaran and Manju Daroach: Study concept and design. Manju Daroach: Drafting of the manuscript. Muthu Sendhil Kumaran: Critical revision of the manuscript for important intellectual content.

Ethical approval

Institutional Review Board approval is not required.

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent.

Conflicts of interest

There are no conflicts of interest.

Use of artificial intelligence (AI)-assisted technology for manuscript preparation

The authors confirm that there was no use of artificial intelligence (AI)-assisted technology for assisting in the writing or editing of the manuscript and no images were manipulated using AI.

Financial support and sponsorship

Nil.

References

  1. , , . What’s bugging you: A closer look at the crab louse. Indian Dermatol Online J. 2022;13:143-4.
    [CrossRef] [PubMed] [Google Scholar]

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