A school nurse is completing routine health evaluations for school-age children. Which of the following manifestation should alert the nurse to the possibility of pediculosis capitis?

A. Eczema: Eczema is a chronic skin condition characterized by inflammation, redness, and itching. It is not typically caused by bacterial infections and does not present with signs around the mouth and nose.

B. Vitiligo: Vitiligo is a condition characterized by the loss of skin color in patches. It is not caused by bacterial infections and does not typically present with signs around the mouth and nose.

C. Angioedema: Angioedema is swelling beneath the skin, often around the eyes and lips, and is commonly associated with allergic reactions or other triggers. It is not caused by bacterial infections.

D. Impetigo: Impetigo is a bacterial skin infection caused by Staphylococcus aureus or Streptococcus pyogenes bacteria. It commonly presents with red sores or blisters around the mouth and nose, especially in children and the elderly. Therefore, option D, Impetigo, is the correct answer.

A. Adhere to strict dietary reduction of oily foods:

Dietary changes, particularly reducing oily and greasy foods, are often recommended as a measure to manage acne. However, the evidence supporting this recommendation is mixed, and strict dietary restrictions may not be necessary for all individuals with acne. Therefore, while the nurse might mention the potential impact of diet on acne, strict dietary reduction of oily foods is not typically the primary focus of acne treatment.

B. Express the larger comedones periodically:

Expressing or squeezing comedones (blackheads or whiteheads) can lead to further inflammation, scarring, and infection. It is not recommended to express comedones at home without proper training and technique. Attempting to express comedones can exacerbate acne and may cause more harm than good.

C. Minimize sun exposure:

Sun exposure can worsen acne and lead to increased inflammation and hyperpigmentation. Therefore, it is important for individuals with acne to minimize sun exposure and use sunscreen with a broad-spectrum SPF of 30 or higher.

D. Use friction when washing the face:

Excessive friction or aggressive scrubbing when washing the face can irritate the skin and worsen acne. Instead, the nurse should advise gentle cleansing of the face using a mild, non-comedogenic cleanser and lukewarm water. Harsh scrubbing or using abrasive cleansers can disrupt the skin barrier and exacerbate acne symptoms.