Is persistent papular urticaria after insect bite manageable?

Question

Hello doctor,

This query is regarding my baby boy’s health. He is 18 months old and recently had his varicella shot last month. Last week, he suddenly started shouting in the middle of his sleep and kept scratching his forehead and neck region. When checked, two mosquitoes were near him and had bitten him.

Generally, he gets papular urticaria after any insect bite. But after three days, he got lesions all over his face, arms, and legs. Checked with my doctor, and initially, it was ruled out as chicken pox along with an insect bite allergy. But even after a week, he still did not show improvement. The older ones are very slowly recovering. But every day new lesions are coming up, and he scratches like anything despite a lot of medications. Please help.

His current medications are Aciclovir half a teaspoon (completed the 5-day course), Azithral one teaspoon (night only) for seven days, and Xyzal half a teaspoon thrice daily. Now the doctor has started him on Omnacortil steroid medication and Kid Pred 3/4 teaspoon twice daily.

Please suggest if we are treating him the right way. He weighs 23.15 Lbs. No fever, cold, or body pain symptoms.

Thank you.

Answer 1

Hi,

Welcome to icliniq.com.

As per the history and pictures shown (attachment removed to protect patient identity), I would recommend getting the child evaluated for scabies if the above treatment does not work. Until then, continue the treatment as going on. It appears to be fine as per my knowledge, as I have not evaluated the child physically.

If the treating doctor feels that it is scabies after examination, it would be advisable to use one dose only of Permethrin 5% on the body and 1% on the scalp.

I hope this helps.

Kindly follow up if you have more concerns.

Thank you.