Recurrent superficial lymphangitis after insect bites

Superficial lymphangitis after arthropod bite: a warning against unnecessary antimicrobial use

“…Important clinical features distinguishing superficial lymphangitis after an arthropod bite from a bacterial infection include the absence of pain, tenderness, fever, lymphadenopathy and a self-limiting clinical course 4. Although most patients, including the present one, cannot recall having been bitten by an arthropod, the presence of a tender macule with a haemorrhagic centre is a useful clue to the correct diagnosis 2…”

“…The injected toxin and inflammatory cells are drained by the lymphatic vessels, causing a linear spread of the inflammation 2 5. The treatment, including topical steroids, oral antihistamines and oral corticosteroids, only addresses the symptoms, but antimicrobials are unnecessary 2–6. In this case, he was initially treated only with a topical steroid but needed additional oral antihistamines due to the deterioration of his condition, suggesting that early antihistamine administration may potentially be beneficial.…”

Linear erythematous rash over the trunk

“…The most common aetiology of this phenomenon is bacterial infection. However, there are other non‐bacterial entities to this as well, examples being arthropod bites and iatrogenic procedures 1–3 . A toxic, allergic, viral or fungal agent can enter the skin and travel to the superficial lymphatic channels which are situated in the deep dermis and subdermal tissues 4 .…”

“…However, there are other non-bacterial entities to this as well, examples being arthropod bites and iatrogenic procedures. [1][2][3] A toxic, allergic, viral or fungal agent can enter the skin and travel to the superficial lymphatic channels which are situated in the deep dermis and subdermal tissues. 4 The erythema streaking seen in this child started from the level of her umbilicus and ran superiorly towards the anterior or pectoral axillary lymph nodes and a small portion to the parasternal lymph nodes.…”

A Pruritic Linear Eruption After an Arthropod Bite

“…1,2 To date, there are only a few cases reported. [1][2][3][4][5] The pathogenesis presupposes a toxic or hypersensitivity reaction to insect toxins, 3 which enter the lymphatic draining vessels and result in a linearly disposed inflammatory reaction of the overlying skin.…”