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Papular urticaria in Adult
Other Resources UpToDate PubMed

Papular urticaria in Adult

Contributors: Craig N. Burkhart MD, Dean Morrell MD, Lowell A. Goldsmith MD, MPH
Other Resources UpToDate PubMed


Papular urticaria is a chronic or recurrent pruritic eruption believed to be an allergic (hypersensitivity) reaction to insect bites. It is very common in children, especially in the spring and summer in temperate climates and year round where the weather is warm. It can occur anywhere on the body but tends to occur on the exposed extensor surfaces of the extremities. A history of exposure to fleas, mosquitoes, chiggers, mites, bedbugs, or other small insects should be searched for.

The lesions are firm, pink, raised, 2- to 8-mm papules, often with a visible central punctum. They may become excoriated or secondarily infected. They can last weeks to months and often recur at the same time each year. Often, only one person in the household is affected and caregivers are disbelieving of proposed cause. After resolution of the papule, pigmented (postinflammatory) macules may persist.


L50.8 – Other urticaria

55608001 – Papular urticaria

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Last Updated:07/19/2021
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Patient Information for Papular urticaria in Adult
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Papular urticaria is believed to be an allergic reaction to insect bites. It is most common in children and often occurs during summer and autumn. The allergic reaction causes bumps on the skin that are red, very itchy, and can develop all over the body. Exposure to mosquitoes, chiggers, fleas, mites, bedbugs, and other small insects is a common risk factor.

Who’s At Risk

Papular urticaria is much more common in children. The reaction can often be caused by insects who live on cats or dogs, such as fleas. Exposure to insects outdoors is another risk factor. It may often affect just one member of the family.

Signs & Symptoms

Red, itchy bumps are the first symptom. They may develop into fluid-filled blisters. These appear most often on the arms and legs. The bumps are intensely itchy and can leave scars if they have been scratched deeply. They typically last from a few days to a few weeks.

Self-Care Guidelines

To prevent exposure, check for any type of insect living in the house including chiggers, fleas, mites, and bedbugs. Use repellents and cover skin with clothing when outside to reduce risk of developing the reaction. If you have pets, treat them for fleas and ticks.

When to Seek Medical Care

If the reaction is severe, or if symptoms do not improve with time, seek medical care.


Your doctor may prescribe topical steroids to treat the reaction. Your doctor may also recommend oral antihistamines such as Benadryl to reduce itchiness.
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Papular urticaria in Adult
A medical illustration showing key findings of Papular urticaria : Erythema, Extensor distribution, Leg, Scattered few, Scattered many, Pruritus, Smooth papules, Insect bite
Clinical image of Papular urticaria - imageId=2040355. Click to open in gallery.  caption: 'Edematous, erythematous papules and plaques on the arm.'
Edematous, erythematous papules and plaques on the arm.
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