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#EntomologyConsult: Why do some patients develop excoriations and scars after insect bites? It seems like a counter-productive move for the immune system
Delayed-type (Tcell mediated) hypersensitivity reactions cause structural degradation of the skin ("spongiosis" seen microscopically). The itch-scratch reflex brings dirty finger nails through the fragile, swollen tissue, removing chunks of flesh. It does seem counterproductive.
Excoriation may remove pathogens inoculated into skin by arthropods, particularly those that need to develop before dissemination. Removal of vectored pathogens would justify this extraordinary neuroimmunologic reflex. I don't have a relevant photo so here is a cute potter wasp
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