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Papular Urticaria: Causes & Treatment

What is Papular Urticaria?

Papular Urticaria is extremely common and uncomfortable chronic papules that erupt time and again due to a hypersensitive reaction after a mosquito, bug bite, or bites of other insects. Papular Urticaria is seen more during the summer and spring seasons even though the incidence rate of this condition remains unknown. Climatic conditions in regions like California this condition tends to affect people throughout the year. With regard to ethnicity, there is nothing mentioned in the literature that suggests that a specific ethnic group gets Papular Urticaria more than others but some studies suggest that Asians are more at risk for developing Papular Urticaria than others [1]. Another study suggests female prevalence of this condition even though it has not been verified by statistics. A survey conducted in India about skin disorders in pediatric patients’ estimated about 5% cases of insect bite related Papular Urticaria. While in the United States, Papular Urticaria is more common in California, it is in Columbia that maximum cases of this condition are believed to be diagnosed. Papular Urticaria is a self-limiting condition and children normally outgrow it with time. Adults however can also get affected with Papular Urticaria even though it is a very small percentage [1]. Papular Urticaria normally lasts for up to a week or more before disappearing. It is not a contagious disease but people with a family history of this condition tend to be at a greater risk. Avoidance of exposure to insects especially mosquitoes is extremely effective in preventing this condition. This article gives an overview of some of the possible causes and treatment options for Papular Urticaria [1].

What is Papular Urticaria?

What Causes Papular Urticaria?

Papular Urticaria in majority of the cases is caused by flea and mosquito bites. Some of the other insects that can cause Papular Urticaria include bed bugs, carpet beetles, and caterpillars. A recent study done on around 2500 children that had been published in World Allergy Organization journal had revealed that around 20% of the children studied had been diagnosed with Papular Urticaria. Among the 20% children with this condition, half of them had fleabite as the cause for it [2]. The risk factors that were considered during the study included presence of mosquitoes or fleas in and around the house and having pets at home. The climatic conditions of the area where the children lived were also taken into consideration, especially if they lived in tropical climate. It has been seen that symptoms of Papular Urticaria tend to improve with a change of home and environment. This further establishes the fact that most causes of Papular Urticaria are due to insect infestation within the living environment [2]. As stated, Papular Urticaria is seen mostly in children although adults can also get it at times. Children below the age of 7 years are most at risk for developing Papular Urticaria. It is quite rare for children above 7 years of age to get this condition. By this age, most children get immune to insect bites due to repeated exposure to these allergens. A consultation with a physician is required as soon as symptoms of Papular Urticaria can be observed. This is necessary to rule out other causes for itchy skin lesions. This will be done by carrying out certain tests and investigations [2]. Some of the other causes for itchy skin bumps include rubella, mononucleosis, and viral infections.

Treatment for Papular Urticaria

Coming to the treatment options for Papular Urticaria, there are a variety of options available. A steroid cream is the most preferred treatment option for Papular Urticaria. They can be applied directly to the affected area for instant symptom relief. In severe cases, the patient may be given oral antihistamines for treatment of the condition and control itching [2]. In some cases, children tend to scratch at the area. This may at times lead to infections. In such instances, the child may have to be given a course of antibiotics which can be topical or oral to treat the infection and clear away the symptoms. It is also necessary to cover the affected area till time the skin lesions fade away. In order to prevent Papular Urticaria, it is important to keep the environment free of any insects [2]. People can take other precautionary measures to avoid risks for Papular Urticaria. These steps include treating pets with medications to tackle fleas. It is also important to clean the pet bedding and spray anti-flea medications over them. It is also necessary to spray insecticides regularly at home or at public places like school to prevent insect bites causing Papular Urticaria. Cleaning carpets and beddings regularly should also be done to prevent bed bugs causing Papular Urticaria [2]. In conclusion, Papular Urticaria is extremely common condition that results due to insect bites. This is most common in children under 7 years of age even though adults may also get it at times. Mosquitoes and fleas are the primary sources of Papular Urticaria. A child with Papular Urticaria will experience small erythematous patches of raised skin that at times may be fluid filled. These raised lesions occur in clusters and develop at the site where the insect bites the child [1, 2]. There will also be severe itching sensation that may last for a few days. There are also a few cases where the symptoms have lasted for more than a week. It is also essential for a consultation with a dermatologist to rule out other more serious causes like a viral infection or mononucleosis as a cause for these symptoms. Steroid creams are the primary mode of treatment for Papular Urticaria. In cases where a child scratches the affected area and an infection develops, then the child will be given a course of antibiotics for symptoms relief and clearing away the infection [2]. Papular Urticaria is definitely preventable and the best way to do it is to keep the home environment clean and free of insects. Pest control is extremely important especially in households where there has been a family history of Papular Urticaria. Regular pest control is also important at public places like school or day care center. With time and as the child grows they develop immunity to these allergens and the incidence of Papular Urticaria go down significantly [2].


Sheetal DeCaria, M.D.
Sheetal DeCaria, M.D.
Written, Edited or Reviewed By: Sheetal DeCaria, M.D. This article does not provide medical advice. See disclaimer
Last Modified On:October 29, 2019

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