LABORATORY OF DERMATOLOGIST REFERAT

MEDICAL FACULTY MAY 2018

PATTIMURA UNIVERSITY

INSECT BITE REACTION

SISKA TEURUPUN
(2012-83-029)

Supervisor:
Dr. Rita Sugiono Tanamal, Sp. KK

T-KL
 Introduction
Insect bite reaction 
Clinical symptoms 
reaction by a bite that
itching, swelling, red
usually originates from
spots, urticaria, macular
the insect's mouth part
formation, papules,
and occurs when an
bullae, vesicles, vomiting,
insect attempts to
diarrhea and
defend itself or when it
anaphylactic shock
searches for its food.
 Introduction
Infants and children are Management of insect
more susceptible to stings depends on the
insect bites than adults type of animal itself

Prevalence of severe reactions

from insect stings is
approximately 0.4%, there are
40 deaths annually in the
United States.
Defenition
Insect bite reaction caused by
a bite that usually originates
from the insect's mouth part
and occurs when an insect
attempts to defend itself or
when it searches for its food.
 Epidemiology
Bites and insect stings have the same
prevalence around the world.

Can be about all ages

Man = woman

Environment that many insects

ETIOLOGY
 Insect bite reaction is caused by
arthropod class insecta
 Insecta is the type of animal that has the
most types and most diverse.
 bites and insect stings are divided into 2
groups namely Venomous (toxic) and non-
venomous (non-toxic).
  There are 30 more types of insects

class Arachnida Class Insecta

a. Acarina a. Anoplura (Pthyreus

pubis, Pediculus
b. Araniae (Spider)
humanus, Capitis et
c. Scorpionidae Class Chilopoda corporis)
(Scorpion) And Diplopoda b. Coleoptera
c. Dipthera
d. Hemiptera
e. Hymenoptera
f. Lepidoptera
Etiology

Insect bites Toxins or allergens

Proteins and other

substances

Allergen reactions
Pathogenesis

insect bites
Eritema, papul,
vesikel, nodul
hemoragik
Saliva

Enzyme hialurodinaze,
kinins, protease
Diagnosis

Clinical
Anamnesis Lab
manifestation
 Clinical
Anamnesis Lab
manifestation
• Patient is • Patients will • Serological
aware of the complain of examination
presence of discomfort, may be useful
insect bites itching, in determining
• the exposure moderate or the infection
is often severe pain, caused by the
unknown erythema, heat, insect vector,
unless there is and edema in but it is rarely
a severe the tissue available and
reaction or around the takes a long
systemic effect bite time to get the
results
Clinical manifestation
Local reaction
discomfort, itching, moderate or severe pain,
erythema, softened, warm tissue and oedem

Severe local reaction generalized erythema,

urticaria, edema, pruritus

Systemic or anaphylactic reactions

symptoms can be mild to fatal, spasms, nausea,
vomiting, shock

Delayed reaction
10 -14 days after sting
similar to serum sickness, fever, malaise, headache,
urticaria, lymphadenopathy and polyarthritis
 Allergic Contact
Dermatitis
Diferential
diagnosa
Scabies

Adverse Cutaneous
Drug Reactions
 Allergic Contact Dermatitis

Acute allergic contact

dermatitis in patients
allergic to acrylates used
in the printing industry
 Scabies

Primary lesions of scabies in

the form of burrows, papules,
nodules, usually pustules and
urticarial plaques located
fingers, flexor area of the wrist,
axilla, antecubital, umbilicus,
genital , gluteal , and foot
Adverse Cutaneous Drug Reactions

Urticaria caused by acetylsalicylic acid

 • DKA
• Insect bite
reaction • Itching,
• Scabies erythema,
• Itching, • Papules, oedem, and
erythema, vesicles, vesiculation
heat, and urtika, and
oedem in the • The skin
others. disorder
tissue around
the bite • with depends on
scratching the severity
• severe erosion, of the
reactions -> excoriation, dermatitis
extensive crusting, and and its
erythema, secondary localization
urticaria, and infection
pruritic
edema
Treatment
Adjusted to the severity of the patient

Topical therapy: compress 3% boric acid solution or

topical corticosteroid such as hydrocortisone cream
1-2%

Severe reaction with systemic symptoms

installation of proximal tourniquets from the site of the bite,
and given a systemic drug
Injectable antihistamines such as chlorpheniramine 10 mg
or diphenhydramine 50 mg. Adrenaline 1% 0.3-0.5 ml
subcutaneous
Prognosis
 Dubia ad bonam
 Except:
- Patients with untreated severe anaphylaxis
- Patients with chronic or severe infection
THANKS