This rash may show up if your child is hypersensitive to bites from bugs such as fleas, mosquitoes, mites, or bedbugs. It's most common between the ages of 2 and 10. Papular urticaria is, of course, more common in places and seasons (such as summertime) with more insects.
Papular urticaria is not contagious.
See what papular urticaria looks like in our visual guide to children's rashes and skin conditions.
Signs and symptoms
Look for small, raised patches of skin that turn into firm, reddish-brown bumps at the site of old insect bites. Bumps are usually very itchy, and are typically found in clusters on exposed areas such as the face, neck, arms, and legs.
The bumps may appear, disappear, and then reappear in another spot. Typically, they don't affect the whole family – just the child who has a sensitivity to insect bites.
The rash can look like many bug bites, but it's more likely one bite or a few bites that have triggered an eruption of hives. The hives are usually gone after a couple of days though they sometimes last for two weeks and they can recur unpredictably.
© Dr P. Marazzi / Photo Researchers, Inc.
Because the original bite may be long gone, papular urticaria can be tricky for doctors to diagnose. According to an article published in 2006 in the journal Infectious Diseases in Children, doctors may order numerous tests or misdiagnose the condition because it's so hard to recognize.
Fleas and bedbugs
Even if you don't have pets, don't rule out fleas. Your child could be bitten by a flea in someone else's house and have a delayed reaction. Most kids are not sensitive, of course, but if yours is, a flea bite can cause a reaction.
As for bedbugs, most of us can't imagine having them in our home, but you might be unpleasantly surprised to discover that it's quite possible. According to the Mayo Clinic, increased international travel, changes in pest control (we no longer use toxic pesticides such as DDT to control bugs), and the bugs' resistance to insecticides have contributed to the return of bedbugs to developed countries such as the United States.
Treatment for papular urticaria
Try calamine lotion or an oral antihistamine. If the itching is severe or the bumps become infected, consult your doctor who may recommend topical steroid creams, oral antihistamines, and corticosteroids.
To prevent the rash, have your children wear insect repellent and keep exposed skin to a minimum. If you have pets, take anti-insect measures. Wash bedding in hot water to fight bedbugs.
Fortunately, kids usually outgrow their sensitivity.
- Pediatric Supersite: Spot the Rash (published in Infectious Diseases in Children, August 2006)
- The University of Kansas Hospital page on urticaria
- Mayo Clinic: Bedbugs