Hives (papular urticaria)

Question 1

Features

Answer 1

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

Question 2

Treatment

Answer 2

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 diproprionate 0.05% ointment to the trunk and limbs

Consider oral antihistamines or corticosteroids in severe cases

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