Papular Urticaria
Allergies
Please click on the link below to access the most up-to-date version of this guideline. The content on this page is currently being updated to align with the latest publication. Always check the version number at the bottom of the screen to confirm which version you are using.
ICD 10 code: L50.8
DESCRIPTION
- Hypersensitivity response to insect bites
- Initial lesion is a red papule, which may blister, become excoriated, and then heal with hyperpigmentation. Usually occur in crops over several months
- Common and often severe in HIV infections (See: Papular pruritic eruption)
GENERAL MEASURES
- Reduce exposure to insects by treating pets, using mosquito nets and fumigating houses regularly. Use of insect repellents may be helpful
MEDICINE TREATMENT
New, inflamed lesions:
- Hydrocortisone 1%, topical, apply daily for 5 days
For relief of itch:
Children
- Chlorphenamine, oral, 0.1 mg/kg/dose 6–8 hourly. See: dosing table
LoE: IVb25
Adults
- Chlorphenamine, oral, 4 mg, 6–8 hourly
Note:
Chlorphenamine is sedating and may only be required in the evening for mild cases
For long term use in adults and school going children:
Children: 2–6 years of age
- Cetirizine, oral, 5 mg once daily. See: dosing table
Children > 6 years of age and adults
- Cetirizine, oral, 10 mg once daily
REFERRAL
- Non-responsive and chronic cases
Standard Treatment Guidelines and Essential Medicines List for South Africa, Primary Healthcare, 2020-2024_Version 1.0_07 November 2024
Chapter 5: Skin Conditions_5.10.4 Papular Urticaria