Suggest Treatment For Skin Lesions Caused By Insect Bites

Posted on Tue, 16 Feb 2016

Question: Greetings. Over the past couple of months I have been getting occasional insect bites in the house. The weather has been warmer than usual in NY, but is pretty chilly now. The bites appear to be like mosquito bites, but are sometimes very simple and sometimes more red and ooze some liquid. Please see attached photo. I clean them with vinegar or alcohol and they go away in about a week, but leave a mark that lasts longer. I have two on my back which I am sending you. Sometimes they are a little dry on the surface, some swell more than others. Again, I don't get them all the time or all over. What do you recommend? Thank you.

Answered by Dr. VINAY KUMAR (1 hour later)

Brief Answer:
Possibility of bedbugs is strong

Detailed Answer:
Hello Dear Sir

Welcome.
I am Dr V XXXXXXX a Sr Dermatologist.

I have seen the attached pic and assessed the details. The combined description very closely matches lesions caused by bed bugs/insect bites.

To anyone attending with me in person, i would have requested a full body examination as well as request them to minutely monitor their items of bed linen as well as surroundings.

For the lesions to resolve fast, the following recommendations are given:

1 Good hygiene by taking measures to iron the loose bed covers, pillow covers, personal clothing, etc

2 Mattresses to be professionally disinfected

3 If other family members are residing with you, then make sure that they either take adequate precautions or treatment depending on their state

3 Sponging with plain water thrice daily followed by application of Mupirocin and Hydrocortisone creams in equal proportions

4 Cetrizine 10 mg or comparable antilallergic tab per day

5 Avoidance of scratching.

Please make best use of this information and stay in touch about your progress.
I will be glad to answer your concerns

Our best wishes.

Above answer was peer-reviewed by : Dr. Arnab Banerjee

Follow up: Dr. VINAY KUMAR (44 minutes later)

Thank you very much. I am studying your reply. The strange thing is that I do not have them all the time and do not find any signs on my mattress or sheets. I go to sleep on my left side, and the bites seem to be more on my exposed right side - hand, arm, toe, back. But they are relatively infrequent once or twice a week or so. If it is not a question of bed bites what other possibility could it be? I am noticing that the itching has decreased since yesterday and the bites are slightly less red. None of the other bites were tiny. All the size of a XXXXXXX or five cents XXXXXXX Our mattresses and fairly new (about a year old). I don't find any markings on the mattress or bedding. Our bedding and comforter are washed regularly with soap and bleach. The only event that has happened was that we needed to change the toilet pipe in the bathroom floor a month or two ago. But everything was well cleaned with bleach, etc.

Answered by Dr. VINAY KUMAR (27 minutes later)

Brief Answer:
Folliculitis can mimic descrption

Detailed Answer:
Hello Dear Sir

Thanks for providing the inputs.

Folliculitis or Ecthyma can sometimes mimic the appearance that has been described. These are bacterial infections which affect skin on anywhere on the body and present as small, sometimes oozy or pus filled lesions that tend to persist as red bumps and the fade away following treatment usually in the form of disinfectants or locally applied antibiotics..

A culture of the discharge from the lesions is a great help in diagnosis.

I have considered other possibilities like Dermatitis Herpetiformis and Erythema Multiforme as well but those present either as clustered lesions or concentric variously colored rings and that does not match description.

For now, it is advisable to have a culture test done and if needed a biopsy can be considered at a later stage.

Starting with the above suggestions is likely to provide immediate relief from symptoms.

To begin with, one should begin with Mupriocin and wait for addition of Hydrocortisone till later after investigations, whereas antiallergic is needed from the very beginning.

Investigations may be undertaken at the earliest.

Please contact me again for any queries. I will be glad to resolve problem.

Best wishes

Above answer was peer-reviewed by : Dr. Arnab Banerjee

Follow up: Dr. VINAY KUMAR (28 minutes later)

Thank you. So you believe these have nothing to do with any insect bites, such as mosquitoes,especially since the bites are mostly on one side of body, i.e. the exposed side?

Of course it is not possible to be sure that my right side is always exposed. But it seems to be the case. I just took one Cetrizine, but you recommend 4 per day? Thanks.

Answered by Dr. VINAY KUMAR (31 minutes later)

Brief Answer:
Antiallergic can be repeated up to twice a day

Detailed Answer:
Hi Dear Sir

Thanks for coming back.

Insect bites is a possibility that cannot be ruled out here. Generally fresh lesions from insect bite will mostly show a punctum or the point through which the insect bites. However, the punctum might not be so apparent after use of medication/ handling.

Cetrizine is generally taken once a day and up to two in most cases on a daily basis are considered safe, unless one gets drowsiness or some other unpleasant side effect. Generally taken in safe doses it is able to deliver the desired results.
Where I mentioned Cetrizine in earlier post, Cetrizine was point number 4 and not 4 tablets. Kindly note the change.

Best wishes, always!

Please

Note: Hope the answers resolves your concerns, however for further guidance of skin related queries consult our Dermatologist.Click here to book a consultation

Above answer was peer-reviewed by : Dr. Prasad