Papular urticaria treatment

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Tips

  • Identifcation and removal of the offending arthropod.
  • Apply permethrin to clothing for 2 week protection, through two washings. It can also be applied directly to exposed skin keeping the insects away for a few days .
  • Apply insect repellents containing DEET (diethyltoluamide) to exposed skin.
  • De-flea cats, dogs and other household pets regularly.
  • Use electrical insect repelling devices and lit coils.
  • Fumigation of the home should also be considered in recurrent cases.
  • Clothes and bedding should be laundered before and after treatment; specifcally, placed in a dryer at 60°C for 10 minutes to dehydrate and kill scabies and bed bugs.
  • Drain pools of stagnating water that attract mosquitoes.
  • Keep windows and doors closed at night.
  • Wear fully covering clothing.
  • Empiric therapy for scabies may be considered.

Medical treatment

For mild cases

  • Mild topical steroids
  • Non sedating antihistamines
    • loratadine
    • desloratidine
    • fexofenadine
    • cetirizine
    • levocetirizine
  • if severe ithcing : diphenhydramine and hydroxyzine.
  • Topical agents
    • Camphor
    • Menthol
    • Calamine lotion
    • Rotamiton
    • Lidocaine,
    • Pramoxine

For severe cases

  • Short-term systemic corticosteroids.
  • Oral prednisone : starting at 1 mg/kg.

For secondary infection

  • Topical or systemic antibiotics

Insect repellents

  • DEET.
  • Permethrin.
  • Thiamine hydrochloride (vitamin B1) : 75 to 150 mg (systemic insect repellent).


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