IGHE and asthma: Pruritus, the hallmark clinical feature of lice infestation, results from an allergic or inflammatory reaction to the lice secretions [3,12]. During the initial exposure, there may be no itching, as sensitization is required for the immunological response [12]. Given this known immunologic response, it is unsurprising that lice infestation could be linked to significant elevations in IgE. Fernandez et al. demonstrated IgE-mediated hypersensitivity reactions to head lice, resulting in recurrent asthma exacerbations [6]. Their patient recovered completely once his head lice were eradicated.