Pediculosis Capitis

A 14-year-old female presented with nits on the whole scalp for the last two  months. It was extremely itchy. Detailed history revealed recurrent episodes of the similar condition for the last four years. She tried multiple medications which gave relief only for few weeks and then condition recurred. A physical examination revealed not only nits and lice but also the secondary bacterial infection and eczematization on the ears, scalp and eyelids also. She was prescribed anti-lice shampoo, topical permethrin, oral and topical antibiotics and mild steroid for eczematization. Her mother was also asked to manually remove nits. After a month she was much improved and now she is on regular follow-up.