Insect Bite

INSECTED BITE
Skin lesions & systemic
illnesses transmitted by
seven subclasses insect :

1.Anoplura.
2.Coleopatra.
3.Diptera.
4.Hemiptera.
5.Hymenoptera.
6.Lepidoptera.
7.Siphonaptera.
ORDER ANOLUPTERA
• Two species  Phthirius
pubis & Pediculus
humanus.
• Pediculosis humanus 
P.humanus varian capitis &
P.humanus varian corporis.
1.
1. PEDICULOSIS
PEDICULOSIS CAPITIS
CAPITIS
• Usually pruritic of the scalp,

hairs become lusterless & dry.
• Suspect in cases  impetigo

& furunkulosis of the scalp or
face in children.
• Secondary infection 
cervical lymph nodes may
become enlarged.
• Diagnosis no difficulties, but
pediculli & nits are so sparse.
• Pediculli easy to mistake
peripheral keratin.
• Treatment :
 Permethrin 1% cream rinse
for shampoo.
The medication  10 minutes
rinsed off, not take for 24
hours afterward, because
resistance 30 - 60 minutes
before rinsing.
 Permethrin 5% cream 
under shower cap to
increase efficacy.
 Pyrethrins + piperonyl
butoxide  applied 10
minutes after washing.
• Re-treatment in a week is
necessary.
• Prevention  combs &
brushes washed.
2.
2. PEDICULOSIS
PEDICULOSIS CORPORIS
CORPORIS
• Synonym : Pediculosis
vestimenti, Vagabond
disease.
• Clinically  generalized
itching, erythematous
macules or urticarial wheals,
parallel linear scratch marks,
pigmented thickening,
secondary furunkulosis.
• Diagnosis  finding the lice
or nits in the seams of
clothing or in bedding.
• Differentiated from scabies 
freedom of the hands & feet.

• Treatment & prevention :
 Clothing in a dryer  30
minutes at 65ºC (149ºF).
 Dry cleaning destroys lice on
wool.
 Pressing woolens with an
iron.
 Should bathe thoroughly with
soap & water.
 1% malathion powder or 10 %
DDT  inner surface of the
underwear.
 Examination of sex partners,
their clothes & the bedding.
3.
3. PEDICULOSIS
PEDICULOSIS PUBIS
PUBIS
• By adults the result of sexual

intercourse.
• Usually  genital region &

hypogastrium.
• Rarely  axillae or eyelashes.

• The lice appearing yellowish
brown or gray specks.
• Difficult to identify  almost
the color of the skin.
• The symptoms  itching.

• Pediculosis pubis frequently
with other sexually
transmitted diseases 
gonorrhea, trichomoniasis,
scabies, non-gonococcal
urethritis, genital warts,
candidiasis, & syphilis.
• Treatment :
 Permethrin 1% cream rinse.
 Permethrin 5% cream form.
 Pyrethrins combined with
piperonyl butoxide.
 Enzymatic egg remover 
such as clear.
• All are applied for 10
minutes after washing.
• Re-treatment in 1 week.
ORDER COLEOPETRA
1.
1. BLISTER
BLISTER BEETLE
BEETLE DERMATITIS
DERMATITIS
• Three major group of
beetles : Meloidea,
Oedemeridae, Staphylinidae.
• Clinical features  slight
burning & tingling, multiple
bullae develop, ”kissing” or
touching lesions.
• In South America, rove beetles
(genus paederus)  patchy or
linear erythematous vesicular
eruption, known as PODO.
• Treatment :
 Drainage of the bullae 
cold compresses & topical
corticosteroid.
 Preliminary cleansing with
acetone, ether, soap, or
alcohol may be helpful.
2.
2. CARPET
CARPET BEETLE
BEETLE DERMATITIS
DERMATITIS
• Causa Antrenus scrophulariae
 larva is reddish brown, fusi-
form, 6 mm long, & covered by
hair.
• Result papulovesicular &
urticarial dermatitis.
• Eruption involves  chest, neck
& forearms.
• Prevention  fumigation of the
house with sulfuryl flouride.
ORDER HYMENOPTERA
Includes :
bees, wasps, hornets & ants.

1.
1. BEES
BEES &
& WASPS
WASPS
• Producing the chemical affects

are a : histamine, mellitin,
hyaluronidase, a high
molecular-weight substance
with acid phospatase &
phospolipase A.
• Reaction : local edema, pain &
pruritus.
• Treatment :
 Ice packs & rubbing with a

dilute solution of meat
tenderizer.
 Oral antihistamin &
analgesic.
 1% triamcinolone diacetate
(or acetonide) & 2% lidocaine
or procaine.
 Oral prednisone, 40 mg/day
for 2 - 3 days.
 0.3 ml epinephrine SC for
severe systemic reactions.
2.
2. ANTS
ANTS
• Symptom : painful, burning,
develops into vesicle, finally
sterile pustules.
• Zeasures & mononeuropathy.

• Treatment :
 Severe pain : intralesionally

injections of triamcinolone.
 Case multiple stings
ephinefrine & systemic
steroid.
ORDER DIPTERA
• Tabanidae : these inflict
extremely painful bites.
• Muscidae : larvae may infest

the skin (myasis).
• Simulidae : painful bites; with

fever, chills, & lymphadenitis.
• Psychodidae : vectors of
cutaneous leishmaniasis,
mucocutaneous leishmaniasis
& verruga peruana.

• Culicidae or mosquitoes :
severe urticarial reactions.
• Ceratopogonidae :
erythematous, edematous
lesions at the site of their
bite.
• Treatment :
 Mosquito bites :
corticosteroid cream.
 Effective for repellent :
diethyltoluamide,
chlorodiethyl benzamide,
ethyl hexanediol, & dimethyl
phythalate.
• Myasis : injection of a local
anesthetic into the skin,
topical ivermectin, surgical
removal for 30 minutes with
15% chloroform.
ORDER LEPIDOPTERA
Includes the
butterflies and moths.

1.
1. CATERPILLAR
CATERPILLAR DERMATITIS
DERMATITIS
• Local pruritic & wheals at the

area of contact.
• Contact urticaria & delayed
allergic contact dermatitis.
• Treatment  antihistamines.
2.
2. MOTH
MOTH DERMATITIS
DERMATITIS
• First sign  severe

conjunctivits & pruritus.
• Afterward  erythematous
papules & ecthymatous
lesions.
• Treatment  topical or oral
corticosteroid.
ORDER HEMIPTERA
1.
1. CIMICOSIS
CIMICOSIS
(Bedbug
(Bedbug bites)  the
bites)  the bedbug
bedbug
(cimex
(cimex lectularius)
lectularius)
• Bite is at first  painless.

• Saliva leads  urticarial or
purpuric reaction,
extensive erythematous &
even anaphylaxis.
• Treatment  menthol or
phenol, topical steroid
creams, & systemic
antihistamine.
2.
2. KISSING
KISSING BUG
BUG
(Reduvil
(Reduvil bites)  assasian
bites)  assasian bugs
bugs
or
or conenoses
conenoses
• Often a red swelling
suggestive of cellulitis.
• Treatment  immunotherapy.
ORDER SHIPONAPTERA
1.
1. PILICOSIS
PILICOSIS (Flea
(Flea bites)
bites)
• Causing hemorrhagic
punctata surrounded by
erythematous & urticarial.
• The lesions often grouped
in zigzag lines.
• Hypersensitivity this
secretion  papular
urticaria or bullae.
• Treatment  corticosteroid
topical.
2.
2. TUNGIASIS
TUNGIASIS
• Is know as chigoe, sand
flea, jigger and nigua.
• Sign  lesion are pruritic
swelling the size of small.

• The usually occur  ankles,
feet, soles toes; less often
anogenital areas.
• Treatment  Curettage or
excision; Thiabendazole 25
mg/kg/day; antibiotics for
secondary infection.

Insect Bite

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INSECTED BITE

Skin lesions & systemic

seven subclasses insect :

• Usually pruritic of the scalp,

• Suspect in cases  impetigo

• Prevention  combs &

or nits in the seams of

• Differentiated from scabies 

freedom of the hands & feet.

• By adults the result of sexual

• Usually  genital region &

• Rarely  axillae or eyelashes.

brown or gray specks.

• Difficult to identify  almost

the color of the skin.

• The symptoms  itching.

minutes after washing.

• Three major group of

• Causa Antrenus scrophulariae

 larva is reddish brown, fusi-

form, 6 mm long, & covered by

bees, wasps, hornets & ants.

• Producing the chemical affects

 Ice packs & rubbing with a

• Symptom : painful, burning,

develops into vesicle, finally

• Zeasures & mononeuropathy.

 Severe pain : intralesionally

• Muscidae : larvae may infest

• Simulidae : painful bites; with

& verruga peruana.

severe urticarial reactions.

lesions at the site of their

anesthetic into the skin,

topical ivermectin, surgical

removal for 30 minutes with

butterflies and moths.

• Local pruritic & wheals at the

• First sign  severe

• Bite is at first  painless.

phenol, topical steroid

creams, & systemic

• Often a red swelling

• Is know as chigoe, sand

flea, jigger and nigua.

• Sign  lesion are pruritic

swelling the size of small.

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