A 25-year-old woman is seen in an urgent care clinic for severe genital itching. She is sexually active with men and reports having sex with a new partner approximately 2 weeks prior. She describes diffuse itching in her pubic region but denies rash, vaginal discharge, or dysuria. A diagnosis of pubic lice is suspected based on clinical history.
Which one of the following is the best method for making a diagnosis of pubic lice?

Figure 1. Pubic Louse and Live Nit in Pubic Hair
Magnified image of a pubic louse (blue arrow) and a nit (red arrow) with both attached to pubic hair. The nit shown here is an example of a live nit—the darker area on the left side of the nit is a developing nymph.
Source: Fuentes-Suárez A, González-Márquez TN. Acrobatic Lice. N Engl J Med. 2017;377:e19.
Reproduced with permission. Massachusetts Medical Society. ©2017.

Figure 2. Nits Attached to Hair
This image shows the difference in appearance between an empty nit and live nit.
Illustration by Jared Travnicek, Cognition Studio
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Question Last Updated
February 4th, 2025
February 4th, 2025
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