PMC10343108_01
(a) Multiple ill-defined small erythematous papules and a few pustules with excoriation on the chest. (b) Brownish grey macules on the upper thighs - maculae cerulae
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F1
Examination revealed multiple ill-defined small erythematous papules with few excoriations on the face, chest, abdomen, back, upper and lower extremities, and pubic region, and some pustules present on the chest and face [Figure 1a]. There were brownish-gray macules chiefly on the upper thighs- maculae cerulae [Figure 1b].
Dermoscopy from the scalp (a), Eyelash (b), Chest (c) and pubic region (d). Brownish crab-like louse clutching on the hair and the skin surface- Phtirus pubis (white arrow), maculae cerulae (orange arrow), transparent whitish crystalline structure devoid of operculum - empty nits (green arrow), ovoid brown structure - active viable nits (blue arrow), nymph (yellow arrow)
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F2
Dermoscopy of the lice on the scalp, face, body, and pubic region [Figure 2] with showed semitransparent whitish crab-like lice with three pairs of legs where the distal two pairs had pincer-like claws clutching on the hair as well as stuck on the skin surface [Figure 3a].
Dermoscopic images: (a) Adult lice, (b) Viable nit, (c) Empty nit, (d) Nymph
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F3
Dermoscopy of the lice on the scalp, face, body, and pubic region [Figure 2] with showed semitransparent whitish crab-like lice with three pairs of legs where the distal two pairs had pincer-like claws clutching on the hair as well as stuck on the skin surface [Figure 3a]. Numerous viable nits which were dark brown in color and convex in shape [Figure 3b] were presently attached to the hairs along with a few transparent empty crystalline nits [Figure 3c]. Nymphs smaller in size [Figure 3d] than the adult lice along with hemorrhagic red dots suggestive of the lice bite were present.
Lice removed from scalp, chest, and pubis when observed under the USB dermoscope. (a) and microscope. (b) All were crab-like short-bodied organisms suggestive of Pthirus pubis
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F4
This was confirmed by observing the lice isolated from these three regions under the USB dermoscope and microscope [Figure 4].