Itchy Business
(Clinical Presentation)
(Clinical Presentation)
The hallmark symptom of pediculosis capitis.
What is pruritus of the scalp?
First-line topical treatment for head lice according to AAP.
What is permethrin 1% cream rinse?
True or false: You must treat the whole household if one child has head lice.
What is false; only close contacts with live lice should be treated?
Mostly likely differential for a child who has scalp pruritus without visible lice.
What is seborrheic dermatitis?
Truth or myth?: Only children with poor hygiene get head lice.
What is myth; lice infest children regardless of cleanliness?
Common sites on the scalp where nits are most often found.
What is the occipital and postauricular regions?
Non-chemical method recommended to remove nits from hair.
What is wet combing with a fine-tooth lice comb?
How long can lice survive off the human scalp?
What is 1–2 days, depending on environment?
Differential for a child who has an itchy scalp with vesicles on erythematous background.
What is allergic contact dermatitis?
Truth or myth?: You can get lice from your pets.
What is myth; human head lice do not infest animals?
The symptoms that explain why a child presents with excoriations and erythematous papules.
What is scratching due to allergic reaction to louse saliva?
This is a treatment consideration when treating infants under 2 months.
What is manual removal only, since topical pediculicides are not recommended?
Advice regarding sharing hats, brushes, or headphones.
What is to avoid sharing these items to prevent transmission?
Differential for a child who has scalp pruritus, patchy hair loss, and scaling.
What is tinea capitis?
Truth or myth?: Shaving the scalp is required to get rid of head lice.
What is myth; topical treatments and combing are sufficient?
These are two common complications of untreated pediculosis capitis.
What are secondary bacterial infection (impetigo) and sleep disturbance?
This is when retreatment with topical pediculicide occur?
What is 7–10 days after the initial treatment to kill newly hatched lice?
Recommended frequency of checking hair for nits after treatment.
What is every 2–3 days for 2 weeks?
Differential for a child who presents with papular scalp lesions, excoriation, and fever.
What is secondary bacterial infection (impetigo/cellulitis)?
Truth or myth?: Head lice can jump or fly from person to person.
What is myth; lice crawl and require direct contact?
This is why aa heavily infested child might still be asymptomatic initially.
What is due to delayed hypersensitivity reaction to louse saliva, which takes 4–6 weeks to develop?
A patient has persistent infestation after permethrin treatment. Name two possible reasons.
What are re-infestation from contacts or resistance to permethrin?
True or false: Household cleaning of bedding, furniture, and toys is critical to eradicate lice.
What is false; routine cleaning is sufficient since lice rarely survive off the scalp?
Differential for an adolescent with chronic pruritus, patchy hair loss, and broken hairs, no nits or lice.
What is trichotillomania (hair-pulling disorder)?
Truth or myth?: Only chemical pediculicides can eradicate lice; home remedies like essential oils are always ineffective.
What is myth; some home remedies may help remove lice/nits, but evidence is limited, and FDA-approved treatments are preferred?