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February 4, 1983

Phthirus pubis Infestation of the Lashes-Reply

JAMA. 1983;249(5):590. doi:10.1001/jama.1983.03330290020015

In Reply.—  As Dr Kincaid correctly stated, in the case of a child infested with P pubis palpebrarum, the physician must consider the possibility of sexual abuse. Follow-up inquiry regarding my 6-year-old patient disclosed that he had spent the day with an uncle who was infested with P pubis of the beard.Regarding the use of lindane near the eye, as Dr Kincaid pointed out, it can be irritating to the eyes, but it is certainly the most effective agent in terms of rapidly and completely eradicating the lice—requiring only one or, at most, two applications of the cream to the lashes in minute quantity. Awan1 recommended two applications of lindane cream five to six days apart. Solomon et al2 advised that the second treatment not take place before eight days, and then only if active organisms can be demonstrated.Regarding concerns about neurotoxic reactions to lindane, Solomon