A Clutching Claw: Unexpected Coexistence of Pediculosis Capitis and Tinea Capitis

Abstract

Introduction: Pediculosis capitis and tinea capitis are very common superficial infections/infestations, primarily affecting school-aged children. The overall pediculosis capitis infestation rate exceeds 25% in some studies, and the occurrence rate for tinea capitis may be as high as 45%. They are more prevalent, but not exclusively, in crowded conditions and environments with low socioeconomic status. Scaly scalp is a common presentation of tinea that may be, at first glance, confused with pediculosis nits. Case Presentation: Here, we describe a case report showing the coexistence of both tinea capitis and pediculosis capitis in a young girl, supplemented with an interesting photograph of a nymph of Pediculus humanus capitis attached by its claws to a hair, with dystrophic endothrix hairs in the background. We also describe further fungal culture performed, with the result and the treatment the patient received. Conclusions: Tinea and pediculosis should always be excluded first in case of a scaly scalp in children. Whether their coexistence is attributed to a causal relation and not simply a poor environment is still to be investigated. This is especially important because body louse is a proven vector for a number of pathogens; however, this is still a matter of debate for head louse.