Summary
Definition
History and exam
Key diagnostic 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 feces on sheets
Risk factors
- high-turnover environment
- recent travel
- secondhand furniture in the home
Diagnostic investigations
Investigations to consider
- skin scraping of lesion (mineral oil preparation)
- skin biopsy
Treatment algorithm
symptomatic disease
Contributors
Authors
Julian J. Trevino, MD
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.
Elizabeth Usedom, MD, MS
Dermatology Resident Physician
Department of Dermatology
Boonshoft School of Medicine
Wright State University
Dayton
OH
Disclosures
EU declares that she has no competing interests.
Acknowledgements
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 reviewers
Richard deShazo, MD
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.
Xuan Nguyen, MD
Faculty Physician
Dermatology and Pediatric Dermatology
Phoenix Children's Hospital
Phoenix
AZ
Disclosures
XN declares that she has no competing interests.
Ian F. Burgess, MSc, MPhil
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.
Differentials
- Insect or spider bite
- Urticaria
- Scabies
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