History:

Patient awoke and noted new onset, itchy, crusted red papules, in clusters on both legs. He had been staying in a hotel in New York. Searched room and found bed bugs in bed frame. These insects have had a resurgence in the US and Britain. In the US, both the East coast (NYC, Philadelphia, Washington, DC) and Midwest (Cincinatti, Dayton, Detroit and Chicago) show the most bed bug infesatations.