Insect Bites and Papular Urticaria

Insect Bites and Papular Urticaria - What it is

Insect bites are commonly seen in children, with mosquito bites being the most common.
Mosquitoes can also spread diseases, such as dengue and malaria. Sand fly bites may occur in sandy areas e.g. beach.

Mosquitoes are attracted to bright clothing, heat and human smells, particularly those of young children.

Children with atopic dermatitis tend to attract insects more than other children and tend to have a more severe reaction.

Papular urticaria is caused by over-sensitivity to a variety of insect bites, especially those of mosquitoes, fleas, bed bugs and mites. It can sometimes occur one or two days after the initial bite.

Insect Bites and Papular Urticaria - Symptoms

Most mosquito bites produce small, red, itchy bumps that resolve after one to two days. However, in some children, they may produce large, very itchy and red wheals, sometimes with blisters that may last for several days. A central "punctum", where the insect has bitten the skin, is usually seen.

Patients with papular urticaria complain of itchy, red, round bumps or wheals, usually on the exposed sites of the body (eg. legs, arms and face). Often the bumps may appear in groups or in a row. Recurrent episodes are common, especially if there is continued exposure to the insects.

In both insect bites and papular urticaria, scratching can result in open, oozy, infected wounds.

After healing, a dark spot (post-inflammatory hyperpigmentation) may appear and last for several months.

Insect Bites and Papular Urticaria - How to prevent?

Prevention of insect bites include the use of insect repellents, mosquito patches, use of protective clothing, and avoiding areas usually infested with insects during the hours of dawn and dusk (eg. Parks, beach). Stagnant water in homes and gardens should be regularly thrown away.

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Insect Bites and Papular Urticaria - Treatments

Treatment of insect/mosquito bites includes oral antihistamines, cool compresses and topical anti-itch agents such as calamine lotion, Suu balm and potent steroid creams.

Treatment of papular urticaria includes oral antihistamines (anti-itch) medications and topical steroid creams. Sometimes, if severe, a short course of oral steroids may be required to decrease the severe itch.

Overview

Article contributed by Dermatology Service, KK Women's and Children's Hospital; Dermatology Service, KK Women's and Children's Hospital

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