Papular urticaria

L50.8


DESCRIPTION

Hypersensitivity response to insect bites.
Initial lesion is a red papule, which may blister, become excoriated, and then heal with hyperpigmentation. Usually occur in crops over several months.
Common and often severe in HIV infections (Papular pruritic eruption, PPE).

GENERAL MEASURES

Reduce exposure to insects by treating pets, using mosquito nets and fumigating houses regularly. Use of insect repellents may be helpful.

MEDICINE TREATMENT

New, inflamed lesions:

  • Hydrocortisone 1%, topical, apply daily for 5 days.

For relief of itch:

Children

Adults

  • Chlorphenamine, oral, 4 mg, 6–8 hourly.

Note: Chlorphenamine is sedating and in mild cases may be used only at night.

For long term use in adults and school going children:

Children: 2–6 years of age

Children > 6 years of age and adults

  • Cetirizine, oral, 10 mg once daily.


CAUTION
Do not give an antihistamine to children < 2 years of age.


REFERRAL

Non-responsive and chronic cases.