Red dots on the waist, shoulders, and axillae progress to papules and wheals with intense itching and small white spheres attached to hair. This describes which infestation?

Red dots on the waist, shoulders, and axillae progress to papules and wheals with intense itching and small white spheres attached to hair. This describes which infestation?

• A. Lice
• B. Fleas
• C. Bedbugs
• D. Scabies

Answer: (A)

The key idea is a lice infestation, indicated by intense itching from feeding and the presence of nits—small white spheres firmly attached to hair shafts. Lice bites cause pruritic papules and wheals as the body reacts to the insect’s saliva during feeding. The note about red dotted lesions on areas with hair and the white spheres on hair specifically points to eggs (nits) of lice clinging to hair shafts. The distribution on the waist, shoulders, and axillae aligns with body lice (Pediculus humanus corporis), which live on body hair and in clothing seams, whereas head lice prefer scalp hair and pubic lice inhabit pubic hair. Bedbugs don’t produce eggs attached to hair, and scabies presents with burrows and mites under the skin rather than nits on hair. So this description fits lice infestation, with the eggs on hair shafts being a classic clue. Management involves eliminating lice and nits, treating exposed skin bites, and decontaminating clothing and bedding, plus treating close contacts as appropriate.

The key idea is a lice infestation, indicated by intense itching from feeding and the presence of nits—small white spheres firmly attached to hair shafts. Lice bites cause pruritic papules and wheals as the body reacts to the insect’s saliva during feeding. The note about red dotted lesions on areas with hair and the white spheres on hair specifically points to eggs (nits) of lice clinging to hair shafts. The distribution on the waist, shoulders, and axillae aligns with body lice (Pediculus humanus corporis), which live on body hair and in clothing seams, whereas head lice prefer scalp hair and pubic lice inhabit pubic hair. Bedbugs don’t produce eggs attached to hair, and scabies presents with burrows and mites under the skin rather than nits on hair.

So this description fits lice infestation, with the eggs on hair shafts being a classic clue. Management involves eliminating lice and nits, treating exposed skin bites, and decontaminating clothing and bedding, plus treating close contacts as appropriate.