Papular urticaria, also called prurigo
simplex, lichen urticatus, and strophulus pruriginosus, i.s a common disease
of infancy and childhood. It appears during the wanner monllis, is more common
in lower social and economic groups, and usually disappears upon admission to
the hospital. Sehaffer, Spencer and Blank in 1948 proved by skin tests with
flea and bedbug
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| Papular urticaria picture |
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| Lichen urticatus. Similar lesions were upon the legs |
antigen that papular urticaria is caused by
hypersensitivity to flea and bedbug bites in at least 90 per cent of the cases.
Their work confirms the suggestions made by Dietrich in Germany in 1938.
Pruritic skin lesions
appear every spring or summer, usually in crops. They are distributed mostly on
the arms and legs, especially on the extensor surfaces; also on the face and
neck and usually least on the trunk. The individual fresh lesions are small
urtieated papules which become rubbed, excoriated and secondarily infected or
liehenified, .sometimes with impetiginous crusts or ccthymatous ulcers.
The lesions recur in crops, usually
at night. All stages of development and regression of the papules may be noted
at the same time. The attack lasts a week or two, but the disease may persist
for months or years. Very frequently the attacks are seasonal. Usually tliere
are no palpable lymphatic glands and no constitutional symptoms.
Treatment is by prophylaxis against all types
of insects. The stool should be examined for intestinal parasites in baffling
cases. The amount of candy, sweets, tomatoes and citrus fruits in the diet
should be regulated. Antipruritic lotions are prescribed. In conjunction it is
advisable to give treatment
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| Papular urticaria |
for fleas by DDT sprayed onto the carpets, floors,
overstuffed chairs, in basements and into dog kennels or sleeping places of
animals (sec p. 441).
