During the summer and fall, one of the most important diseases in children’s nighttime emergency clinics as well as in pediatric dermatology daytime clinics is insect bite dermatitis. Looking at the itchy, conservative mosquitoes and itchy babies, every mother wants to know how to prevent and treat insect bite dermatitis. So, what kind of disease is it? Insect bite dermatitis is an inflammatory skin disease caused by the bite of arthropods, including mosquitoes, midges, whiteflies, fleas, bedbugs, and contact with their venom or insect burrs. The saliva of these insects contains a variety of antigenic components that enter the skin and can cause toxic and/or allergic reactions resulting in dermatitis. The local manifestations of the skin are often manifested as papular urticaria. The most common dermatitis caused by arthropod bites in summer and autumn, of which 60-70% are caused by insects, such as mosquito bites, bee stings, lice disease, tick bites, etc. Insect bite dermatitis on the human body damage mechanisms include 1, mechanical damage, such as mouthparts, tail hooks direct damage to the skin; 2, venomous venomous hair damage, such as wasps, scorpions, centipede venomous juice and the toxic reaction of mulberry caterpillars poisonous hair. Toxins can be divided into: herpetotoxin, which can cause local skin blistering blisters; neurotoxins, which invade the nervous system causing respiratory paralysis and death; hemolytic and hemorrhagic toxins affect the human blood clotting system, leading to bleeding and blood clots. The most serious problem caused by toxins is anaphylaxis, but the condition is rare.3. Invasive insect damage, such as fly maggot disease, larvae of scabies mites, and insects causing disease within human skin.4. Stinging blood damage, such as flies, mosquitoes, and fleas can transmit a variety of diseases by sucking blood. Clinical manifestations: self-conscious itching and / or pain, subcutaneous larvae migration when visible lesions change location. Patients often feel itchy and like to scratch. Movement of the joints adjacent to the affected area is usually not significantly affected. Elevated skin temperature may be evident at the affected area. Edematous bumps, papules or petechiae on the contact or bite site may appear as well as blisters and associated lymphadenopathy and inflammation without significant fluctuation or tenderness or pressure. Treatment aims: to block and counteract inflammatory mediators, relieve discomfort, eliminate dermatitis symptoms, protect vital organs if necessary, and save lives. Local treatment: The bee stinger will remain at the skin and cannot be absorbed, it must be removed or excised. Tick bites should never be pulled out directly to avoid their tick head residue. You can use a thin line tied in a live knot at the tick’s neck and pull gently for 3-4 minutes until the tick head retracts on its own, then stomp it to death. You can also thickly coat the head of the tick with petroleum jelly, liquid paraffin, or glycerin to suffocate it, and then gently pull the tick out with forceps, if the residual tick head in the skin needs to be surgically removed. For caterpillar-like toxin irritation, the first step is to use a more sticky tape to repeatedly tape the affected area to remove residual toxic hairs, and thereafter clean the affected area as well as medication. When local edema is evident, cold compresses are an important means of reducing swelling. Commonly used cold compress solutions are 3% boric acid solution, vinegar and 5% sodium bicarbonate or 5-10% ammonia. 3% boric acid solution, vinegar is mainly used when the poisonous juice is alkaline, such as caterpillars and wasp poisonous juice; while 5% sodium bicarbonate or 5-10% ammonia is used when the poisonous juice is acidic, such as bees, scorpion stings. Camphor, menthol, local anesthetics, furnace glycolic lotion and glucocorticoids can be used topically to stop itching. Because camphor has low toxicity, it needs to be used under the guidance of doctors, especially for infants and children under 2 years old to avoid overuse and misuse. And the use of camphor can cause premature birth, fetal death and neonatal jaundice to pregnant women, so pregnant women should not use the substances containing camphor and synthetic ice chips (which have some camphor) as much as possible. Infants and children should also pay attention to the use of such products should not be too large doses, and to avoid accidental intake. For the people with G-6PD phosphatase deficiency (sericea), camphor can induce hemolysis and other toxic reactions, so it should be avoided. In some patients, large blisters may appear at the insect bites. When the herpes is too full, the herpes fluid should be aspirated, and after the wound is broken, local zinc oxide oil or ointment astringent can be applied, and if there are signs of infection, topical antibiotics are needed. Commonly used topical antibiotic ointments include 2% mupirocin, 2% fusidic acid, and compounded polymyxin B ointment. The choice of the above medications needs to be determined by a licensed physician based on the location and severity of the infection. For larval migrans and fly maggot disease, oral insecticides such as ivermectin and albendazole are required; for scabies, topical insecticides such as sulfur ointment are often used, but remember to apply them under the guidance of a physician to achieve good results and to keep side effects to a minimum. Systemic medications: Oral antihistamines such as chlorpheniramine, diphenhydramine, cetirizine or loratadine are required for severe itching and should be selected by a licensed physician based on the child’s age, weight and condition, especially to avoid overdose. Short-term systemic glucocorticoid therapy may be considered for patients with moderate to severe pruritus and edema. Patients with anaphylaxis should be given 1:1000 epinephrine 0.2-0.5 ml for first aid. Management of acute abdomen with specific symptoms: black widow spider toxin can cause severe abdominal pain and platysmal abdomen. In most patients, injection of opioids and benzodiazepines can relieve the pain. Specific antitoxin therapy is used only if the patient has a severe toxic reaction along with no contraindications to allergies or if pain medications are ineffective. Treatment of comorbidities: Patients suspected of having rickettsial or Lyme disease after a tick bite should be treated with the appropriate antimicrobial agents, while paying attention to the presence or absence of combined bleeding and coagulation system abnormalities. Children with tick bites should also be aware that their toxins may cause “tick paralysis”, which manifests as episodic paralysis with a serious prognosis and high mortality, so the tick needs to be removed before serious comorbidities arise and the patient will recover quickly. Preventive principles: 1, eliminate environmental stagnant sewage to reduce mosquito breeding; 2, protect the natural enemies of mosquitoes in nature such as frogs, bats and birds; 3, the screen window and screen door annual inspection, good protection; 4, as far as possible to use physical repellent measures, such as fans and mosquito nets; 5, reduce body sweat, mosquitoes are mainly through the body sweat in lactic acid and exhaled carbon dioxide to find the object of attack; 6. The use of mosquito repellent. The main application of mosquito repellents on the market is to avoid mosquitoes amine (DEET, N-N-Diethyl-toluamide) and repellent ester (BAAPE, Dimethyl phthalate1,2-Benzenedicarboxylic acid, Imodium), they mainly through the blocking of insect sensory receptors to play a role, mosquito repellent effect The effect of BAAPE (Dimethyl phthalate1,2-Benzenedicarboxylic acid) is definite. However, in 2013, it was also reported in the UK that mosquitoes that had been exposed to DEET would become resistant to it and the effectiveness of mosquito repellent would be greatly reduced. In terms of application history, DEET has more than 60 years, it has low toxicity, mainly in terms of causing local skin irritation and inducing neurological damage such as epilepsy. The repellent can not be applied directly on the skin, and must be washed after use to remove residues. At the same time, DEET is fat-soluble and can dissolve plastics and synthetic fibers as well as cause nail polish discoloration. Canada recommends that children aged 2-12 years apply DEET to repel mosquitoes, the concentration should be less than 10%, and should be used less than three times a day; children under 1 year, less than one application per day; infants under 6 months are not recommended. The American Academy of Pediatrics recommends that children over 6 months of age should apply DEET at a concentration of less than 30%; infants under 2 months of age are not recommended. Repellent ester (BAAPE) is a new mosquito repellent developed by Merck in Germany based on the improvement of DEET, which has been officially registered by the World Health Organization in the United States, the current study results that it is safer than DEET, water-soluble, infants and children can be safely applied, but the history of clinical application is still short, should still avoid excessive use; 7, the use of mosquito coils; the active ingredients of mosquito coils are Pyrethroid insecticide. Solid mosquito incense ultra-fine particles have an impact on the airway, more than the use of liquid mosquito incense and flake mosquito incense is also inappropriate. Be sure not to buy insecticides containing organochlorine or organophosphorus, while taking strict care not to let children accidentally take mosquito liquid; 8, some articles report oral vitamin B1 and its dilution applied to the exposed skin can also play a certain role in mosquito repellent, but its efficacy is not as accurate as mosquito repellent and repellent ester. I hope that every mother who loves her baby can hold up a sky without mosquitoes for her baby, and in case her baby is bitten, she can do the right treatment to reduce pain and avoid complications and sequelae.