Papular Urticaria

Papular urticarial is an allergic reaction of the skin to insect bites. It is common in children who have atopy or dry skin. The primary function of our skin is barrier function; it protects from environmental factors. Children with dry skin have nonefficient barrier function, so they give hyperactive reactions for otherwise simple insect bite. Children with age in between 2-10 have more predilections for this condition.

As I said, papular urticarial is hypersensitivity or hyperactive immune response to insects bite. We have not found specific insects which cause it, but  One such specific mite we know is Peymotes ventricosus, and it is also known as the “grain itch,” “barley itch,” “straw itch,” “hay itch,” “prairie itch,” “mattress itch,” and “cottonseed itch,” sometimes evident occupationally in farmers, bakers, antique dealers,  dock workers, packers, and indoor workers. These mites are invisible to the naked eye.

Papular urticaria presents with itchy reddish colored bumps, mostly overexposed parts of the body like forearms, legs. Children who have papular urticaria have recurrent episodes, so such symptoms appear and disappear depending on their exposure to insects bite. Papular urticaria is more common in the winter season. It tends to get better as age advances, and it is relatively uncommon after the age of 12years.

Due to continuous scratching, children tend to damage their skin; this damaged skin is easy prey for bacterial infections.

• It is a clinical diagnosis, the clinician can easily diagnose the condition on presenting symptoms, and rarely any investigations are needed.
• How papular urticaria treated?
• Topical steroid creams
• Topical antibiotics or oral antibiotics
• Oral anti-inflammatory or oral steroid

• Preferably use of cotton cloths
• Cover the entire body as far as possible
• Use of mosquito nets
• Use of pesticides to control of insects as and when requires
• Use of moisturizer daily