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Skeeter syndrome (papular urticaria) is a localized severe allergic reaction to mosquito bites, [1] consisting of inflammation, peeling skin, blistering, ulceration and sometimes fever. It is caused by allergenic polypeptides in mosquito saliva , and therefore is not contagious. [ 2 ]
The term papular urticaria [4] is commonly used for a reaction to mosquito bites that is dominated by widely spread hives. Here, papular urticaria is regarded as a symptom of mosquito bite allergy manifested in individuals with one of the other mosquito bite allergies but particularly in those associated with eosinophilic cellulitis.
Hives, also known as urticaria, is a kind of skin rash with red and/or flesh-colored, raised, itchy bumps. [1] Hives may burn or sting. [2] The patches of rash may appear on different body parts, [2] with variable duration from minutes to days, and do not leave any long-lasting skin change. [2]
Rodent mite bites leave multiple groups or individual small itchy papules (around 1–2 mm in diameter) [7] on the skin (papular urticaria). [ 9 ] [ 10 ] These are found mostly "on the upper extremities, neck, upper trunk and face".
The first outbreak of urticaria can lead to other reactions on body parts not directly stimulated, scraped, or scratched. In a normal case, the swelling will decrease without treatment within 15–30 minutes, but, in extreme cases, itchy red welts may last anywhere from a few hours to days.
[9] [10] Treatment primarily involves managing symptoms and includes the use of antihistamines, corticosteroids, monoclonal antibodies , and in some cases, immunosuppressive drugs. [11] [12] Despite ongoing research, many aspects of autoimmune urticaria remain poorly understood, and it continues to be a challenging condition to manage.
Topical antihistamines are not advised as there might be a second skin reaction (treatment associated contact dermatitis) from the lotion itself. The other symptoms caused by allergic contact dermatitis may be eased with cool compresses to stop the itching. It is vital for treatment success that the trigger be identified and avoided.
Cholinergic urticaria typically presents with a number of small papular hives all over the body, that involve cutaneous inflammation (wheals) and severe nerve pain, which usually develops in response to exercise, bathing, staying in a heated environment, spicy foods, or emotional stress.