How is papular urticaria treated?

Updated: Feb 12, 2021
  • Author: Robert A Schwartz, MD, MPH; Chief Editor: Dirk M Elston, MD  more...
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The treatment of papular urticaria should be conservative and is symptomatic in most cases. Mild topical steroids and systemic antihistamines for relief of the itching that often accompanies this condition may be used. On occasion, papular urticaria may be severe enough to warrant the use of short-term systemic corticosteroids. If secondary impetigo occurs, topical or systemic antibiotics may be needed. Note that the use of insect repellents while the patient is outside and the use of flea and tick control on indoor pets are necessary when these individuals are being treated for papular urticaria.

Rigorous use of an effective insecticide may prevent insect bites and, accordingly, papular urticaria. Insecticides containing diethyltoluamide (DEET) are among the most beneficial. For safety purposes, topical insecticides used on infants and children should be in accordance with their age. DEET, picaridin, PMD (para-menthane-3,8-diol), and IR3535 are suitable for protection against arthropod bites; IR3535 is not suitable for Anopheles mosquitoes. [33] Use of protective clothing, insecticide-treated bed nets, and insecticide-treated clothing is desirable. The main elements responsible for the high prevalence of papular urticaria caused by flea bites in Bogotá, Colombia might be modified by these and similar strategies. [34]

An oral desensitization vaccine has been attempted, but the vaccine was deemed ineffective and the study sample size was too small for statistical significance. [35]

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