GuidelinesEML (Adult Hospital STG)
Papular Urticaria
Standard Treatment Guidelines and Essential Medicines List for South Africa, Hospital Level, Adults 2019 Edition
L50.8
DESCRIPTION
- Papular urticaria is a hypersensitivity disorder to insect bites, resulting in recurrent and sometimes chronic itchy papules on exposed areas of the body.
- An initial lesion appears, usually as a red papule, which may blister, become excoriated, and then heal with hyperpigmentation. Lesions usually occur in crops over several months.
- Chronic, severe, persistent reactions may be seen in immunocompromised patients, e.g. HIV infection, immunosuppressive therapy, and malnutrition.
GENERAL MEASURES
- Reduce exposure to insects by treating pets, using mosquito nets and fumigating the household regularly.
- Use of insect repellents may be helpful.
- Examine carefully for burrows to rule out scabies.
MEDICINE TREATMENT
New inflamed lesions:
- Potent topical corticosteroids, e.g.:
- Betamethasone 0.1%, topical, apply daily for 5 days.
LoE:IVbxiv
For sedation and relief of itch:
- Chlorphenamine, oral, 4 mg at night as needed in severe cases.
REFERRAL
- Non-responsive and chronic cases.
Standard Treatment Guidelines and Essential Medicines List for South Africa, Adult Hospital Level, 2020-2024_Version 1.0_07 November 2024
Chapter 4 Dermatology_4.9.1 Papular Urticaria