Dermoscopy allows a rapid and reliable diagnosis of pediculosis by revealing the lice itself or the nits fixed to the hair shaft (Fig 9b).Nits containing vital nymphs dermoscopically display ovoid brown structures, while the empty nits are translucent and typically show a plane and fissured free ending. This information is particularly useful for treatment monitoring, since dermoscopic detection of vital nits should lead to a continuation or modification of therapy. Additionally, dermoscopy has been recently shown to enable the discrimination between nits and the so-called pseudo-nits, such as hair casts, debris of hair spray or gel. The latter are not firmly attached to the hair shaft and appear dermoscopically as amorphous, whitish structures.
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