20 The authors noted that nearly 32 of children with five or more nits close to

20 the authors noted that nearly 32 of children with

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20 The authors noted that nearly 32% of children with five or more nits close to the scalp converted to active infestations versus 7% of those with fewer nits. 20 Nits found more than 1 cm from the scalp are not usually viable and those 2 - 5 cm from the scalp are likely to be remnants of a past infestation, although in warmer climates viable nits can be found more than 20 cm (8 inches) from the scalp. 1,5,19 Misidentification of Head Lice Misidentification occurs frequently leading to unnecessary treatments and exclusions from school. 6 The identification of head lice was so inaccurate in one study that children without active infestations were excluded from school more often than children with active infestations. 6 Nits can be confused with many other materials including dandruff, scabs, dirt, sand, lint, residue left from hair spray, hair casts and other debris. 3,5,14 Unlike nits, the materials above are easily removed from the hair shaft. 3,14 Confirmation of an infestation should include questioning about other materials that may have confused the 6
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