CHAPTER 15 BITING AND STINGING INSECTS 247
Mosquito Bite Dermatitis and Hypersensitivity
Mosquito avoidance.
Application of repellants to face and pinnae.
Topical corticosteroid sprays effective for individual lesions.
Prednisolone (2–4 mg/kg q24h tapering dosage) or dexamethasone (0.1 mg/kg q24h
tapering dosage).
Environmental clean-up to remove mosquito breeding sources.
Tick Bite Dermatitis and Hypersensitivity
Manual removal of ticks.
Corticosteroids for inflammatory reactions.
Antibiotics as indicated for secondary infection.
Hymenoptera
Remove stinger(s).
Antihistamines (see Appendix B).
Corticosteroids.
Topical corticosteroid sprays effective for individual lesions.
Prednisolone (2–4 mg/kg q24h tapering dosage).
Reduce exposure.
Systemic support.
Hyposensitization can be very effective in patients with prior incidences of anaphy-
laxis.
Portable epinephrine administration devices are available for use by the owner when
reexposure is unavoidable.
COMMENTS
Insect avoidance and control should be stressed as the primary method to prevent
recurrences.
Symptoms may be seasonal and/or geographical variation dependent on insect pop-
ulations.
In situations where complete avoidance of insects is not possible, reduction in expo-
sure will simplify and reduce medications needed to control symptoms.