Two Copulatory Lice with a Harasser on Scalp Hair

A 19-year-old girl with secondary leukopenia and a 3-week history of itchy scalp was diagnosed with pediculosis capitis, caused by head lice, after staying at a hotel. Dermoscopy revealed multiple erythematous papules, viable and hatched nits, and adult lice, including two mating lice harassed by a male louse and a nymph. The patient was treated with 10% sulfur ointment and hair shaving. Dermoscopy proved useful for diagnosing and monitoring the condition by visualizing lice and distinguishing between viable eggs and empty nits.