Papular urticaria is a common skin disorder which is characterized by the emergence of clusters of red papules on the skin.
These papules are recurrent or chronic and are usually a result of hypersensitivity to insect bites such as mites, bedbugs, fleas, mosquitoes or some environmental factors.
The papules surround a wheel and display a central punctum. It is also termed as an allergy often. It occurs in skin parts that are usually exposed and not covered by clothing.
In this article, we will know about all the details of papular urticaria.
The onset of papules starts after a single insect bite. By the time the affected individual notices the reaction, the bite is usually gone, so it is difficult to detect the cause.
The urticarial pruritic lesions in papular urticaria are usually 0.2-2cm in diameter and may last for days or weeks together. Hence, technically it is not true urticaria as true urticaria lasts only for a few hours.
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Whom Does Papular Urticaria Affect?
Papular urticaria is most commonly seen in children in the age group of 2 to 10. Because of their extended exposure to different insects and bugs while playing outdoors. Also, children have less resistance to the disorder as compared to adults.
However, it is not entirely restricted to children as some adults can get it too. The occurrence in grown-ups is very rare.Also, it is often seen that people with pets are prone to be affected by this disorder. This is because pets are carriers of several fleas on their bodies.
A pet cat, at an average, can carry approximately 20 fleas on its body along with several of their eggs.Hence, the possibility of flea bites and the resulting hypersensitive reaction is more likely around pets.
Is Papular Urticaria Seasonal?
Although it cannot be supported by concrete evidence, papular urticaria is more common during spring and summer months. This is because of the presence of some insects during the time.
It usually gets resolved in the cold winter months. However, in places with hot climates in general, children may get this disorder at any time of the year.
What Are The Causes Of Papular Urticaria?
This condition is known to be triggered by an initial insect bite such as fleas, mites, bugs or mosquito. The resulting occurrence of lesions is an allergic reaction to the bite.
It is important to note that the insect bites may elicit a hypersensitive reaction in only certain individuals and not everyone.The affected individuals may never know what caused the reaction since the bite is gone till the symptoms start showing.
Here are the insects capable of causing papular urticaria:
- Fleas and other insects thriving on pets
- Mosquito bites
- Presence of bed bugs in the house
- Caterpillars
- Moths
- Gnats
A small parasite called as pyemotes ventricosus or straw itch mite that lives in other small insects can also be responsible for the reaction.
The insect is very small and cannot be seen by the naked eye.It feeds on the blood of its host insect. Papular urticaria cases amongst farmers, packers, bakers and indoor workers are attributed to this insect.Now, the possibility of bed bugs might be cringeworthy, but it is possible that the bugs may have been transported passively, through clothing or luggage. Old furniture, sheets or mattresses may also carry bugs often.
Since bed bugs are active during the night, they usually bite in the night and also inject an anesthetic.
Therefore, the initial bite is not felt by the affected individual. As the symptoms of the allergic reactions may take days to show up, it is hard to attribute the cause to a bed bug bite.Another major cause of the skin disorder is a flea bite from the fleas that breed upon the pets in our house. Even if one doesn’t have pets, one shouldn’t rule out fleas as the cause of the problem.
It is possible that your child was bitten by a flea at someone else’s place and might be having a delayed reaction due to the bite.Also, in places where there are a lot of insects, the chances of getting bug bites or insect bites are quite high, and hence the possibility of papular urticaria is high.
Symptoms Of Papular Urticaria
The most common symptom of papular urticaria includes several clusters of red colored crops, usually 0.2 to 2 cm in diameter.
These bumpy spots can be very itchy and annoying.The lesions appear like several crops of bug bites, but they are all likely to originate from just a single bug bite.
They are most often seen on the hands, legs or other exposed parts of the skin like face, neck or forearms.However, they are sometimes seen in several small clusters all over the body, including the areas of the skin that are covered.
The eruptions of papular urticaria are likely to linger for a few days before disappearing completely and then recurring after a few days in some other area of the skin.
Papular urticaria initially manifests itself as pruritus or itching. This intense itching sensation evokes scratching from the affected person who is very difficult to avoid.
Right after the itching starts, the onset of the firm, reddish-brown lesions or crops occurs. Due to excessive scratching of the lesions, it may cause serious infection.
This will eventually cause the lesion to become sore and swollen and also provoke old lesions to reoccur and cause even more itching.Sometimes the spots develop fluid or puss-filled blisters that are up to 1 cm in diameter. The spots usually remain for a few days or weeks and may leave stubborn marks or scars, especially if they have been scratched too hard.
The distribution of spots is somewhat symmetrical and may be localized to a certain part of the body where the insect bit you. They may also develop at the site of an old bite from an insect.However, it is quite a possibility that they will be later spread to other parts of the body too due to infection.
Is Papular Urticaria Contagious?
No, usually papular urticaria is not contagious. It depends upon the person’s resistivity to insect bites and fleas. Sometimes, multiple members of the family may get the same allergic reactions.
But, that might be due to the presence of bugs or fleas in the house which they might not be resistant to. It does not imply the contagious nature of the disorder.
Treatment Of Papular Urticaria
Papular urticaria is not a serious or dangerous condition. It is usually just very inconvenient and annoying due to the excessive itchy feeling and presence of several red spots on the body.
It persists for a few weeks or days and then resolves itself on its own, only to reappear spontaneously after a while.The urticaria mostly affects children due to their low resistivity to the allergic reaction. However, with time, children become desensitized and immune to it and get cured of it permanently.
Hence there is no particular treatment to cure it before it gets resolved on its own. Until the time, the only way to manage the disorder is to avoid any insect bites and provide relief from itching and soreness and prevent an infection due to scratching. Here are the treatment or remedies to get rid of the itchiness that may cause infection:
1. Avoid Getting Bitten By Any Arthropod:
This is the best way to manage this condition. If you can avoid insect bites, then the chances of an allergic reaction will be diminished greatly. Apply insect repellant creams at all times, especially if you have pets or if you are going outdoors. Permethrin (5%) can be used as an insect repellent as it repels many biting arthropods (except fleas) for about a week.
Also, try to wear full-sleeved clothing and cover your body as much you can. The lesser skin you expose, lesser will be your chances of getting a hypersensitive reaction from bites.
2. Antiseptic Cream:
An antiseptic cream or an ointment can be used to prevent any secondary infection due to excessive scratching of the lesions.
3. Insecticides:
In places with a large number of insects, insecticides can be used to rid the schools, homes, and playgrounds of insects that may cause the allergies in kids.
4. Topical Steroid Cream:
This can be applied for relief on the affected skin as soon as the lesions start to appear.
5. Oral Antihistamine:
Histamines are beneficial in reducing itchiness and to prevent further development of lesions.
6. Topical Soothing Lotion:
Calamine lotion can be used as a topical soothing lotion to relieve itching.
Home Remedies To Get Rid Of Papular Urticaria
Some home remedies that help are:
1. Peppermint Oil:
When taken orally, it gives instant relief in papular urticaria.
2. Essential Oils:
Essential oils, especially chamomile is very helpful in this condition as it alleviates the redness and itchiness of the skin.
3. Herbal Teas:
Herbal teas like parsley or peppermint are great for treatment of papular urticaria. When consumed regularly, they help in reducing redness, itchiness, and inflammation of the affected region.
4. Turmeric Paste:
Turmeric paste can be applied topically to the affected area of the skin. It has natural soothing properties, and hence it will provide relief from itchiness and inflammation.Another way is to consume water infused with turmeric powder once a day till the symptoms start to disappear.
5. Garlic:
Consuming garlic is known to have effects similar to NSAIDs (Non-steroidal Anti-inflammatory Drugs).Just crush a few cloves of garlic and consume it with raw honey at least twice a day. It will be very effective in providing relief from papular urticaria.
6. Table Salt And Water:
Consume a glass of water with a spoonful of table salt every day. It is helpful in providing relief to the itching and inflammation of the skin.
7. Aloe Vera Gel:
Aloe Vera gel can be applied to the affected area to reduce inflammation. This is because aloe vera has a cooling effect and will provide great relief if you have scratched the affected area.
8. Oatmeal:
Oatmeal is a very good remedy for papular urticaria. Simply soak oatmeal in water for 10 minutes and let it absorb the water. Later, add some more water to it and filter the paste through a thin cloth.Use the collected murky water to apply to the affected area for instant relief from inflammation.
Bottom Of Line
Papular Urticaria is a skin disorder which involves the occurrence of red itchy spots on the skin triggered by an insect or flea bite due to hypersensitive allergic reactions. It is most common in children but can affect adults as well.
It is a self-resolving condition and does not have any serious implications on the health of the affected individuals. If you get the disorder, make sure to avoid scratching too much as it may worsen the situation and cause more eruptions on your body.
The best way to deal with it is to avoid any insect bites by using insect repellents and taking other precautionary measures not to get bitten. As the disorder is self-limiting, it cures itself by becoming immune to it with time.
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