Pediatric Phthiriasis Palpebrarum: A French Multicentric Retrospective Study of 20 Cases

Phthiriasis palpebrarum is an ectoparasitosis caused by Phthirus pubis. We lack data on managing this condition in pediatric populations. The aim of this multicenter retrospective study from France was to describe the clinical characteristics, the modes of transmission, and the treatments of children affected by phthiriasis palpebrarum.

Records of phthiriasis palpebrarum cases that occurred in children <18 years from 2005 to 2024 were retrieved from 9 dermatology departments and 1 liberal office in France.

A total of 20 children with phthiriasis palpebrarum were included. The median age at diagnosis was 3 years and 2 months (range: 7 months-8 years). The median delay in diagnosis was 28.5 days (range: 1 day-5 months). Ocular pruritus (83%), eyelid erythema (44%), crusting of the free eyelid margin (41%), and scalp involvement (55%) were the main characteristics. A case of P pubis infection in close contacts was identified in 12 patients (63%). The mode of contamination was identified in 53% of cases. No case of sexual abuse was found. The majority of patients were treated with ivermectin, topicals, and mechanical removal.

Contrary to the previous reports in the literature about pediatric phthiriasis palpebrarum, scalp involvement is a typical finding. Regarding the mode of transmission, no sexual abuse has been identified, but the origins of infantile phthiriasis palpebrarum weren't systematically discerned to assess for possible abuse. Notably, no case was registered after the age of 8 years. Different treatment protocols are used, reflecting a lack of standardization.