A preschool-aged girl tells the school nurse that her hair hurts. The nurse finds that the child's hair has been arranged to cover several small bald spots. Which finding indicates to the nurse that the hair loss is not disease-related?

Rationale for A: Erythema of localized lesions may indicate an inflammatory condition or infection, which could suggest that the hair loss is disease-related. Rationale for B: Evidence of patches of lost haircan be due to cosmetic products or abuse hence not conclusive Rationale for C: Episodic complaints of pruritus could indicate an allergic reaction or infestation, which suggests a possible disease-related cause for the hair loss. Rationale for D: Ecchymotic blood accumulations suggest trauma to the scalp. C. Episodic complaints of pruritus (itching) might suggest irritation but do not conclusively indicate the hair loss is not disease-related. D. Ecchymotic blood accumulations indicate bruising but are not typically associated with hair pain or loss.