INSECT BITE REACTION

Isnaeni Salamiyah Andi Fatmawati Mahir Surahmayanti Tahir

I. INTRODUCTION
Insect come from Latin word which is insectum and the meaning is cut into three section, head, thorax, and abdomen. Insect bite reaction caused by the toxin/ allergen released from anthropod. important disease vectors & easily spread which the self protection from insect very important.

II. EPIDEMIOLOGY
Prevalent throughout the world. Insect bite happens all ages, equal in men and women.

III. ETIOLOGY
The class insecta contains several orders of medical importance : Diptera (flies, mosquitoes), Coleoptera (beetles), Hemiptera (bedbugs, kissing bugs), Siphonaptera (fleas), Hymenoptera (ants, bees, wasps) and Lepidoptera (butterflies and moths).

Picture 1. Pictorial key to groups of human ectoparasites

PATHOGENESIS
Hypersensitivity tipe I

Hypersensitivity tipe II

IV. DIAGNOSIS
a. Anamnesis History activities in outdoor for example when the patient has spent the afternoon in the garden on a hot day in summer and subsequently develops typicval lession on exposed areas of skin.

b. Clinical findings With subsequent bites, a delayed reaction occurs, consisting of pruritic papules which develop approximately 24 hours after the bites.

Picture 2. (a) Papular urticaria. (b) Linear edematous papules and vesicles

Clinical findings in every ordo of insecta a. Ordo Diphtera

Picture 3. eritema and nodul

b. Ordo Coleoptera

Picture 4. (a) blister beetle (b) linear eritematous vesikuler eruption

c. Ordo Shiponaptera

Picture 5. (a) Flea (b) clustered urticarial papules

d. Ordo Hemiptera

Picture 6. (a) bed bug (b) papular urticaria

e. Ordo Hymenoptera

Picture 7. (a) Fire ant (b) Multiple pustules in cluster

f. Ordo Lepidoptera

Picture 8. (a) Puss caterpiler (b) railroad track purpura

V. LABORATORY FINDINGS
Bacterial Culture

Histopatology

Serology

VI. DIFFERENTIAL DIAGNOSIS

1. Prurigo A pruritic disorder runs a chronic course.

Picture 8. Multiple firm, exoriated nodules

2. Urtikaria
Urticaria is a vascular reaction of the skin due to various causes, usually characterized by local edema. That quickly arise and disappear slowly

Picture 10. Wheals with white-to-light pink in the face

3. Atopic dermatitis

VII. TREATMENT
1. Topical treatment : if mild reaction happen, compress with acid bonat solution 3% or topical corticosteroid such as hidrocortison cream 1-2%. If severe reaction happens with systemic symptom fix the tourniquet proximal from the bite area and give systemic medicine. 2. systemic treatment : inject antihistamine such as chlorpheniramine 10mg ordiphenhidramine 50 mg. Adrenalin 1% 0,3-0,5 ml by subcutan.t