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ARTHROPOD BITES

( = mosquitoes, fleas, flies, chiggers, ticks, wasps, bees, and hornets)

Difficulty to diagnose in children = unaware of the source of the lesions


deny being bitten

CLINICAL MANIFESTATIONS.
Depends on -
species of insect
age group
reactivity of the human host.

injury by various mechanisms,


mechanical trauma
invasion of host tissues, as in myiasis;
contact dermatitis, exposure to cockroach antigens
granulomatous reaction to retained mouth parts
transmission of systemic disease
injection of irritant cytotoxic or pharmacologically active substances, such as
hyaluronidase, proteases, peptidases, and phospholipases in sting venom

induction of anaphylaxis.

reactions to arthropod bites =

When someone is bitten for the first time, no reaction develops.


immediate petechial reaction
After repeated bites, sensitivity develops, producing a pruritic papule

Arthropod bites may occur as solitary, numerous, or profuse lesions,

Delayed hypersensitivity = firm, persistent papules ,become hyperpigmented

Pruritus may be mild or severe, transient or persistent

immediate hypersensitivity reaction = erythematous, evanescent wheal.


Even shock rarely

Complications of arthropod bites – shock and death rarely occurs


Common problems are
Impetigo
Folliculitis
Cellulitis
lymphangitis,
Papular urticaria occurs in = fleas, mites, bedbugs, gnats, mosquitoes, chiggers, and
animal lice.
Individuals with papular urticaria have predominantly transitional lesions in various

TREATMENT.

Alleviation of pruritus by oral antihistamines, cool compresses, and soothing lotions such
as calamine,
Topical corticosteroid creams are rarely effective
Topical antihistamines have no role in the treatment
Short course of systemic steroids may be helpful
Insect repellents containing diethyltoluamide (DEET) may give protection against
mosquitoes, fleas, flies, chiggers, and ticks
but relatively ineffective against wasps, bees, and hornets.
permethrin-impregnated clothing;

identify and eradicate the etiologic agent.


Pets should be carefully inspected;

Agents that are effective for ridding the home of fleas include lindane,
pyrethroids(=Synthetic pyrethrin derivatives that are used as insecticides), and organic
thiocyanates.