The mite is large, so when present, it is easily visible. Sometimes the mite is not seen but the elliptically shaped eggs, which resemble hookworm eggs, are present. Be suspicious of Cheyletiella in a patient with "chronic hookworm" disease as you may be mistaking Cheyletiella eggs for hookworm eggs. The typical presentation of a patient with Cheyletiella is one with "dandruff" but I have had patients present with periocular crusting, acral lick granulomas, chronic sneezing and just plain pruritus with very little if any dandruff.