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Updated: Nov 9 2016


  • Snapshot
    • An 18-year-old man presents to his primary care physician with an itchy rash. He recently backpacked through Europe, staying at hostels along the way. He remembered that other people in his travel group complained of itchiness, but didn't think much of it. Every day, he woke up with a few more lesions on different parts of his body.
  • Introduction
    • Skin rash caused by bite of Cimex lectularis or “bedbugs”
    • Bugs spread on clothing, bedding, mattresses, and laundry
      • hide during the day
      • feed during the night
    • “Breakfast, lunch,and dinner” linear pattern
    • Skin inflammation often result of allergic reaction to bedbugs
  • Presentation
    • Symptoms
      • pruritus at site of rash
    • Physical exam
      • erythematous, edematous papules
      • often seen in a linear pattern
  • Evaluation
    • Diagnosis made by clinical exam and history
  • Differential Diagnosis
    • Scabies
    • Chiggers
    • Other bug bite
  • Treatment
    • Treatment often not needed as bug does not remain on skin
    • For itch
      • topical steroids
      • antihistamines
    • Sterilize laundry
    • Exterminator to inspect home
  • Prognosis, Prevention, and Complications
    • Prognosis
      • very good
      • heals within 1-2 weeks
    • Prevention
      • avoid places with bedbugs
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