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Image Number #8862 (Bed Bug Bites)

Diagnosis: Bed Bug Bites

Description:

Typical papular urticarial response

Morphology: Papules,red

Site: Arm,forearm

Sex: F

Age: 65

Type: Clinical

Submitted By: Ian McColl

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Differential Diagnosis
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History:

Case from Dr 

65 year old lady stayed at a popular hotel in the south west of WA. She developed itchy forearms and hands while there, and a worsening rash, which persisted for weeks. Her husband developed a mild facial itch a minor rash only. She contacted the hotel proprietor, who acknowledged she was not the first to note such a rash. Topical steroids were used to treat this papular urticaria and the local public health authority notified about the hotel's bedbugs!

Good example. I had a very similar case recently. People vary in their immunological reaction to the bite. She had a much greater reaction than her husband who was also bitten at the same time. Usually a short course of oral steroids is required to rapidly shut the inflammation down. Antihistamines wont help this problem as it is a Type 4 immune reaction ie cell mediated rather than Type 1 and histamine. (Submitted By: Dr Ian McColl)
 

 

 

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