Last reviewed: 24 Jan 2021
Last updated: 01 Dec 2020

Summary

Definition

History and exam

Key diagnostic factors

  • presence of risk factors
  • bed bug sighting
  • irregular linear erythematous papules
  • new skin lesions noted in the morning
  • pruritus

Other diagnostic factors

  • pain or burning
  • papular or diffuse urticaria
  • bullae
  • widespread urticaria/wheezing/stridor/hypotension
  • specks of blood or faeces on sheets

Risk factors

  • high-turnover environment
  • recent travel
  • second-hand furniture in the home

Diagnostic investigations

Investigations to consider

  • skin scraping of lesion (mineral oil preparation)
  • skin biopsy

Treatment algorithm

Contributors

Professor of Dermatology

Chair

Department of Dermatology

Boonshoft School of Medicine

Wright State University

Dayton

OH

Disclosures

JJT declares that he has no competing interests.

Dermatology Resident Physician

Department of Dermatology

Boonshoft School of Medicine

Wright State University

Dayton

OH 

Disclosures

EU declares that she has no competing interests.

Dr Julian Trevino and Dr Elizabeth Usedom would like to gratefully acknowledge Dr Suzanna Dundon and Dr David Carr, previous contributors to this topic.

Disclosures

SD and DRC declare that they have no competing interests.

Peer reviewersVIEW ALL

Chairman and Professor

Department of Medicine

Professor of Pediatrics

Billy S. Guyton Distinguished Professor

University of Mississippi Medical Center

Jackson

MS

Disclosures

RD declares that he has no competing interests.

Faculty Physician

Dermatology and Pediatric Dermatology

Phoenix Children's Hospital

Phoenix

AZ

Disclosures

XN declares that she has no competing interests.

Professor

Director

Medical Entomology Centre

University of Cambridge

Cambridge

UK

Disclosures

IFB has been a consultant to various manufacturers of pharmaceutical products, alternative therapies, and combs for treating louse infections. IFB is an author of a number of references cited in this topic.

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