Diagnosis and treatment of insect bite dermatitis (papular urticaria)

  Papular urticaria is a common papular skin disease of children and adolescents.  Etiology: Mostly due to the bite of certain arthropods such as mosquitoes, fleas, mites, midges, bedbugs and other bites caused by allergic reactions, but also due to digestive disorders, allergies to certain foods.  Clinical manifestations: Occurs in the summer. Mostly seen in children, adults can also be more frequent. The lesion is a 1 to 2 cm large reddish papule, slightly fusiform, with a small blister in the center, sometimes evolving into a large blister. It often occurs in batches on the abdomen, lower back, buttocks and both lower legs, more clustered and less fused. If it occurs on the distal extremities, large blisters may form. The rash gradually fades after 3-7 days, leaving pigmentation, but can continue to occur and gradually heal after several weeks. Patients generally have no systemic symptoms, but may have swollen lymph nodes and fever if there is a secondary infection. Symptoms may decrease and stop at an older age (7-8 years).  Treatment: Our treatment uses anti-allergy medication plus topical hormones. Furfuryl can be applied externally to the papules during the day, and topical application of Diazinon camphor thin at night.