PAPULAR URTICARIA

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Lesions due to insect bite often grouped or in a linear arrangement, show a central bite mark and are on exposed areas of the body.

Initial lesion is a red papule, which may blister, become excoriated, and then heal with hyperpigmentation.

Usually occur in crops over several months.

Chronic, severe, persistent reactions may be seen in immunocompromised patients, e.g. HIV infection, immunosuppressive therapy.

GENERAL MEASURES

Reduce exposure to insects by treating pets, using mosquito nets and fumigating household regularly.

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Use of insect repellents may be helpful.

Examine carefully for burrows to rule out scabies.

New inflamed lesions:

  • Betamethasone 0.1%, topical apply daily for 5 days.

For relief of itch and sedation:

  • Chlorpheniramine, oral, 4 mg at night as needed in severe cases.

REFERRAL

»     Non-responsive and chronic cases.

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