Thread by @skinandall_

#dermatologyteaching
It's been a while hasn't it? That's because most of the other topics are so hardcore dermatology and may be a little hard to comprehend. Lol
Let's talk about a condition called papular urticaria.
This common condition is often seen in infants and children.

Usually due to a hypersensitivity to bites from insects, fleas,mosquitoes, mites, bugs...etc. The group of people that develop papular urticaria are thought to develop a blood spread material (an antigen) after the bite which then causes them to have a generalized reaction.

Although the reaction is more common on the limbs, it also can be seen on the trunk and other areas. So in essence, after a bite.. people with papular urticaria will have more generalized itching and swelling apart from the bite area.

Most times, you might not even see what is biting them. So some people can attribute it to 'attacks from village people'...lol. The word papule in dermatology means a raised lesion on the skin less than 0.5cm (whatever the color). How does papular urticaria present?

Usually as symmetrical (affecting both sides almost equally) raised itchy lesions on the limbs (arms and legs). The typical history is that the individual scratches those lesions which peel off and then heal with post inflammatory hyperpigmentation leaving the limbs spotted.

This keeps running a vicious recurring cycle each time the person is exposed to such bites. As most children grow older, they actually outgrow it. However those spots may take time to fade out especially if they're a lot.
How then do you manage?

The single most important aspect of management is to protect the skin from the bites. Wear long sleeved tops and trousers instead of shorts. Apply insect repellant cream to exposed areas. Give some itch relief medications called antihistamines when its itchy. Moisturize the skin.

For doctors....counsel your patients. It always goes a long way in management when you're on the same page with your patients. It boosts confidence in the doctor and peace of mind for the patient.
Pictures from researchgate via Google images. The first one is the early stage.

And the second is the final stage when it heals with post inflammatory hyperpigmentation and the limbs are now spotted.
Any questions and comments will be answered on the thread...

@threadreaderapp please unroll. Thank you