Insect bite-induced hypersensitivity and the SCRATCH principles: a new approach to papular urticaria

Insect bites and the associated hypersensitivity reactions known as papular urticaria account for a significant number of all referrals from pediatricians and dermatologists to our pediatric dermatology clinic. Unfortunately, children affected by these eruptions are frequently misdiagnosed and often...

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Bibliographic Details
Published inPediatrics (Evanston) Vol. 118; no. 1; p. e189
Main Authors Hernandez, Raquel G, Cohen, Bernard A
Format Journal Article
LanguageEnglish
Published United States 01.07.2006
Subjects
Child, Preschool
Diagnosis, Differential
Female
Humans
Hypersensitivity - diagnosis
Hypersensitivity - metabolism
Hypersensitivity - therapy
Immunohistochemistry
Infant
Insect Bites and Stings - complications
Insect Bites and Stings - diagnosis
Insect Bites and Stings - metabolism
Insect Bites and Stings - prevention & control
Male
Urticaria - etiology
Urticaria - metabolism
Urticaria - therapy
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Summary:Insect bites and the associated hypersensitivity reactions known as papular urticaria account for a significant number of all referrals from pediatricians and dermatologists to our pediatric dermatology clinic. Unfortunately, children affected by these eruptions are frequently misdiagnosed and often subject to expensive evaluations including invasive and unnecessary procedures. Here we review the course of 4 children with the typical physical findings and natural history of these reactions. On the basis of our clinical findings and experience with this patient population, we propose a set of principles (termed "SCRATCH") as clinical features to aid clinicians in making an early and accurate clinical diagnosis. We conclude that a more appropriate term for future study and diagnosis of this entity is insect bite-induced hypersensitivity.
ISSN:1098-4275
DOI:10.1542/peds.2005-2550