What is of papular urticaria?

Updated: Feb 12, 2021
  • Author: Robert A Schwartz, MD, MPH; Chief Editor: Dirk M Elston, MD  more...
  • Print


Papular urticaria is a common and often annoying disorder manifested by chronic or recurrent papules caused by a hypersensitivity reaction to the bites of mosquitoes, fleas, bedbugs, and other insects. Individual papules may surround a wheal and display a central punctum. [1]

See When Bugs Feast: What's Causing that Itch?, a Critical Images slideshow, to help identify various skin reactions, recognize potential comorbidities, and select treatment options.

Although the overall incidence rate is unknown, papular urticaria tends to be evident during spring and summer months; in some climates, such as that in San Francisco, California, this condition may affect children throughout the year. In addition, despite no known racial or sex predisposition, certain ethnic groups (specifically Asians) may be more predisposed to more intense reactions, and a small Nigerian study reported a slight female predominance for skin diseases such as papular urticaria and atopic dermatitis. [2] Papular urticaria was evident in 2.24% of 5250 first-time pediatric patients, with 6029 diagnoses in one pediatric dermatology service survey. [3] A survey of skin disorders in more than a 1000 new pediatric patients at a hospital in Bangalore, India found insect bite reactions and papular urticaria in 5.1% [4] A Nigerian survey of 491 pediatric dermatoses in 441 patients found papular urticaria in 6.7% of them. [5] . Papular urticaria is also common in Colombia, linked with exposure to indoor fleas and poverty. [6]  In Bogotá, Colombia among children aged 1-6 years, it was the most common skin disease, evident in more than 60% of them. [7]

This eruption is primarily self-limited, and children eventually outgrow this disease, probably through desensitization after multiple arthropod exposures. [8, 9] However, adults can be affected, albeit at a much lower rate.

Did this answer your question?
Additional feedback? (Optional)
Thank you for your feedback!