A 13-year-old girl in Nonthaburi, a province bordering Bangkok, was so afraid of touching the lice in her hair that she stopped washing and grooming it altogether, leaving it tied in a ponytail. By the time she reached dermatologists, her hair had formed irreversibly matted masses that the doctors compared to a bird's nest, with adult lice, eggs, and dandruff visibly packed inside.
The rare condition, called plica polonica, was only part of the story. After a standard 10-minute application of 1% permethrin lotion, a considerable number of adult lice were still alive. Genetic testing later showed that every louse sampled carried two copies of a mutation linked to insecticide resistance. Researchers at Chulalongkorn University and King Chulalongkorn Memorial Hospital in Bangkok reported the case on Feb. 9 in Tropical Medicine and Health.
