Summary about Disease
Papular urticaria is a common skin condition characterized by small, raised, itchy bumps (papules) that typically appear in groups. It is often a hypersensitivity reaction to insect bites, particularly those from fleas, mosquitoes, mites, or bedbugs. While it can affect people of all ages, it's most prevalent in young children.
Symptoms
Small, raised bumps (papules) on the skin.
Intense itching (pruritus).
Bumps often appear in clusters, commonly on exposed areas like arms, legs, and trunk.
Bumps may have a small central punctum (a tiny red spot indicating the bite).
Scratching can lead to secondary skin infections.
Lesions can appear in crops over several weeks or months.
Causes
Insect bites are the primary cause, specifically reactions to the saliva injected by insects like:
Fleas (most common)
Mosquitoes
Mites (including scabies mites)
Bedbugs
In rare cases, other insect bites or stings might be involved.
Poor hygiene and overcrowding can contribute to infestations and increased risk.
Medicine Used
4. Medicine used
Topical corticosteroids: To reduce inflammation and itching (e.g., hydrocortisone cream).
Oral antihistamines: To relieve itching (e.g., cetirizine, loratadine, diphenhydramine).
Topical anti-itch creams: Calamine lotion or pramoxine-containing creams can provide temporary relief.
Antibiotics: If secondary bacterial infection develops from scratching.
Severe Cases: In rare, severe cases, oral corticosteroids may be prescribed by a physician for short-term relief.
Is Communicable
Papular urticaria itself is not communicable. It is a reaction to insect bites, not an infectious disease. However, if scabies mites are the cause, then the scabies infestation is communicable through close skin-to-skin contact.
Precautions
Insect repellent: Use insect repellent containing DEET or picaridin, especially during peak insect activity times.
Protective clothing: Wear long sleeves and pants when outdoors, especially in wooded or grassy areas.
Treat pets for fleas: Regularly treat pets for fleas and ticks to prevent infestations.
Eliminate insects in the home:
Vacuum regularly, paying attention to carpets, rugs, and upholstery.
Wash bedding frequently in hot water.
Consider professional pest control if you have a significant infestation.
Avoid scratching: Try to avoid scratching the bumps to prevent secondary infections. Keep nails short.
Maintain good hygiene: Regular bathing can help prevent skin infections.
How long does an outbreak last?
An outbreak of papular urticaria can last for several weeks or even months, particularly if exposure to the causative insect continues. Individual bumps typically resolve within a few days to a week, but new bumps may continue to appear as new bites occur. The duration depends on the individual's sensitivity, the number of bites, and how effectively the source of the bites is eliminated. Lesions may leave behind post-inflammatory hyperpigmentation (dark spots) that can take months to fade.
How is it diagnosed?
Clinical examination: Diagnosis is usually made based on the characteristic appearance of the skin lesions and the history of insect bites.
Patient history: The doctor will ask about recent insect exposures, travel, pets, and other relevant factors.
Dermoscopy: A dermatoscope can help visualize the central punctum of the bite.
Skin scraping: If scabies is suspected, a skin scraping may be performed to look for mites under a microscope.
Allergy testing: Rarely, allergy testing might be done to rule out other causes of urticaria.
Timeline of Symptoms
9. Timeline of symptoms
Initial bite: Insect bite occurs.
Within hours to a day: Itchy bump starts to form at the site of the bite.
Days 1-3: Bump enlarges and becomes more intensely itchy. A central punctum might be visible.
Days 3-7: Itching may persist; scratching can lead to excoriations and potential secondary infection.
Days 7-14: Individual bumps start to resolve, but new bumps may appear if further bites occur.
Weeks to months: Post-inflammatory hyperpigmentation (dark spots) may remain after the bumps have healed.
Important Considerations
Secondary infection: Monitor for signs of secondary bacterial infection (increased redness, pus, pain, swelling). If present, seek medical attention.
Differential diagnosis: Other skin conditions can mimic papular urticaria. A doctor can help differentiate it from conditions like eczema, scabies, and chickenpox.
Chronic papular urticaria: If symptoms persist for longer than six weeks, it may be considered chronic, and further investigation may be needed to identify underlying causes.
Prevention is key: Focus on preventative measures to avoid insect bites.
Consult a doctor: If symptoms are severe, widespread, or accompanied by other symptoms (e.g., fever, difficulty breathing), seek medical attention promptly.