Arthropod bite or sting in Infant/Neonate
Reactions may be more pronounced in the immunocompromised patient. An exaggerated, sometimes bullous reaction to an arthropod bite is characteristic of certain immunosuppressed states, especially a hematopoietic malignancy or HIV disease. In HIV-infected individuals, arthropod assaults may result in an extremely pruritic skin eruption called "pruritic papular eruption."
Arthropods include insects (stinging or venomous hymenoptera [eg, bees, wasps, fire ants] and non-venomous insects [eg, mosquitos, chiggers, fleas]) as well as ticks, mites, spiders, scabies, and body lice. Other arthropods often remain unidentified.
Arthropods may transmit human illness (including tick bite fever, Lyme disease, Rocky Mountain spotted fever, a variety of encephalitides, malaria). Venomous bites may trigger systemic toxic or allergic reactions, including anaphylaxis. An ascending paralysis caused by a neurotoxin may occur after a tick bite.
Some arthropod infestations, such as pediculosis capitis, scabies and crusted scabies, are highly contagious and pose a particular problem in the institutional setting.
There are highly variable global distributions of insects and arthropods. In returning travelers, insect bites are the fourth most common skin complaint diagnosed.
T63.481A – Toxic effect of venom of other arthropod, accidental (unintentional), first encounter
409985002 – Arthropod bite wound
Differential Diagnosis & Pitfalls
Urticarial / papular dermatoses:
- Cutaneous mastocytosis (urticaria pigmentosa or mastocytoma)
- Pityriasis lichenoides et varioliformis acuta (PLEVA)
- Lymphomatoid papulosis
- Papular acrodermatitis of childhood (Gianotti-Crosti syndrome)
- Cutaneous lymphoma / leukemia cutis
- Immunoglobulin A vasculitis (formerly Henoch-Schönlein purpura)