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Image Number #8428 (Insect bite reaction)

Diagnosis: Insect bite reaction

Description: pruritic,excoriated,erythematous prurigo papules

Morphology: Papules

Site: Buttocks

Sex: M

Age: 4

Type: Clinical

Submitted By: Kiran Nabar

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Differential Diagnosis
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History:

 

             This is flea bite reaction. In books it is mentioned that flea bite reaction occurs on lower parts of legs up to 1 foot from ground.  This is because fleas hop up to that distance. I have observed in my practice that flea bite  lesions usually occur on covered areas.  When kids play with dogs and cats ,these fleas accidentally enter under the closes . They are trapped in areas  where clothes are snuggly fitting. eg. waistline area, buttocks, anterior and posterior  axillary folds, upper back, scapullary area etc. Vaults of axillae are spared being concve areas where fleas can remain undisturbed. I think under fear and insecurity, just as protective mechanism they bite.(It is rule of nature) 

               Sometimes there is no history of contact with dogs or cats. In such cases, if one is strongly suspecting flea bite reaction, he should ask history of playing in sand or in bushes or in grass. Fleas when fall off from dogs and cats , after feeding, they remain in sands or bushes or grass where these animals have gone.

DermNetNZ   eMedicine   PubMed   Dermatology Online   Archives   JAAD for "Insect bite reaction"

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