Hives (Papular Urticaria)

Features

• Persistent itchy papules due to hypersensitivity from insect bites

• Any biting insect, esp. fleas, mosquitoes, sandflies, mites, bed bugs

• Commonest in children 2–6 yrs

• Small weals evolving to firm reddish papules grouped together

• Persist for days, sometimes wks

Treatment

• Soothing lotion or cream (in preferred order):

  • – phenol 1% or menthol 0.5% in oily calamine lotion or menthol 1% cream

  • – crotamiton 10% lotion

  • – Ego Soov Bite

• Topical corticosteroids (e.g. betamethasone dipropionate 0.05% ointment to the trunk and limbs)

• Consider oral antihistamines or corticosteroids in severe cases

Note: Prevention is best, esp. in those prone to hives.