Which Finding Noted by the School Nurse While Conducting Pediculosis

Which finding noted by the school nurse while conducting pediculosis capitis (head lice) checks indicates the need for treatment?

A) White,flaky particles throughout the scalp region
B) Lesions on the scalp that extend to the hairline or neck
C) Maculopapular lesions behind the ears
D) Silver/white sacs attached to the hair shafts in the occipital area