Enechukwu Nkechi A
Department of Internal Medicine, Nnamdi Azikiwe University, Nnewi, Anambra State, Nigeria.
Clin Exp Dermatol. 2025 Aug 9. doi: 10.1093/ced/llaf380.
Pediculosis capitis, caused by human head lice, is a common yet frequently overlooked cause of scalp pruritus. While historically uncommon in adults, recent reports indicate a rising incidence, particularly among adult females. This case series highlights the diagnostic challenges of pediculosis capitis infestation in adult females from Southeastern Nigeria, where persistent scalp itch is often misdiagnosed and treated as seborrheic dermatitis, leading to delayed or inappropriate management. We present four cases of females aged 20-41 years with persistent scalp pruritus initially misdiagnosed as seborrheic dermatitis but later confirmed as pediculosis capitis through trichoscopy. These cases underscore the importance of considering pediculosis capitis in the differential diagnosis of any case of scalp pruritus, especially in geographical regions with a high prevalence of pediculosis capitis infestations. Health care providers (HCPs) often overlook head lice infestation as a potential cause of scalp itch due to its resemblance to other common scalp conditions, potentially delaying treatment and promoting spread through shared hair grooming tools. Increased awareness among HCPs and the use of trichoscopy can facilitate accurate diagnosis, prevent unnecessary treatments, and improve patient outcomes. Pediculosis capitis remains a neglected yet significant cause of scalp itch, warranting greater attention in clinical practice.
头虱引起的头虱病是头皮瘙痒的常见但常被忽视的原因。虽然历史上头虱病在成年人中并不常见，但最近的报告表明其发病率在上升，尤其是在成年女性中。本病例系列突出了尼日利亚东南部成年女性头虱病感染的诊断挑战，在该地区，持续性头皮瘙痒常被误诊为脂溢性皮炎并进行治疗，导致管理延迟或不当。我们报告了4例年龄在20 - 41岁的女性，她们最初被误诊为脂溢性皮炎，但通过毛发镜检查后来确诊为头虱病。这些病例强调了在任何头皮瘙痒病例的鉴别诊断中考虑头虱病的重要性，特别是在头虱病感染高发的地理区域。由于头虱感染与其他常见头皮疾病相似，医疗保健提供者（HCPs）常常忽视头虱感染是头皮瘙痒的潜在原因，这可能会延迟治疗并通过共用头发梳理工具促进传播。提高HCPs的认识并使用毛发镜检查有助于准确诊断，防止不必要的治疗，并改善患者预后。头虱病仍然是头皮瘙痒被忽视但重要的原因，在临床实践中值得更多关注。
