Seborrheic or atopic eczema of the scalp can cause scaling and itch, but it lacks the key finding of nits (eggs) cemented to the hair shafts, which is diagnostic for head lice.
Scalp folliculitis presents as pustules at the base of hair follicles, not as the excoriations and nits seen with a lice infestation.
This is characterized by greasy, yellowish scale, whereas the "dandruff" of head lice is composed of empty nit casings and is accompanied by live nits on the hair.
