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On-line version ISSN 1806-4841
An. Bras. Dermatol. vol.86 no.1 Rio de Janeiro Jan./Feb. 2011
IMAGING IN TROPICAL DERMATOLOGY
Bedbugs (Heteroptera, Cimicidae): an etiology of pruritus to be remembered*
Paulo Ricardo CriadoI; Roberta Fachini Jardim CriadoII
IPhD in Sciences (Dermatology) awarded by the School of Medicine, University of São Paulo. Physician, Dermatology Department, Teaching Hospital, School of Medicine, University of São Paulo, São Paulo, Brazil
IIMaster's degree in Medicine awarded by the State Civil Servants' Healthcare Institute of São Paulo. Specialist in allergies, Department of Dermatology, ABC School of Medicine, São Paulo, SP, Brazil
This report describes a 19-year old female patient, who sought medical attention for severe itching of two weeks' duration. Erythematous papules and wheals were found, principally on her upper and lower limbs. Careful anamnesis excluded other etiologies of the pruritus, including those related to internal diseases and medication. Following counseling regarding the need to contract a domestic pest control company, the patient returned to the clinic three weeks later with no skin lesions and bearing a glass jar containing several bedbugs collected following pest control treatment.
Keywords: Bedbugs; Cimicidae; Prurigo
A 19-year old woman sought medical attention at this clinic complaining of intense itching for two weeks' duration, particularly during the night. The presence of papules and erythematous wheals were found, principally on her limbs, some of which formed a sequential pattern (Figure 1). This pattern of the lesions resembled bites of sucking insects. Anamnesis excluded the use of any medication, the presence of comorbidities, the presence of mosquitoes or fleas in the home and the possibility of any other family members being affected. The patient was instructed to contract a pest control company to decontaminate the apartment in which she lived because of a suspicion of Cimicidae. Despite the patient's incredulous reaction to this diagnosis, three weeks later she returned to the clinic, reporting that she had had a pest control company fumigating her home and that she had recovered numerous insects, some containing blood (Figure 2).
C. lectularius is the principal cause of bites and its presence is widespread. 1,2 The insect has an ovoid, flattened body, with no wings. It is found in homes and hotels, in wood, mattresses, wallpaper, and in birds' nests. 1,2 International travel and the resistance to insecticides has contributed to the resurgence of Cimicidae. 3
1. Doggett SL, Russell R. Bed bugs - What the GP needs to know. Aust Fam Physician. 2009;38:880-4. [ Links ]
2. Pritchard MJ, Hwang SW. Cases: Severe anemia from bedbugs. CMAJ. 2009;181:287-8. [ Links ]
3. Delaunay P, Blanc V, Dandine M, Del Giudice P, Franc M, Pomares-Estran C, et al. Bed bugs and healthcare-associated dermatitis. Emerg Infect Dis. 2009;15:989-90. [France] [ Links ]
Mailing address: Approved by the Editorial Board and accepted for publication on 03.02.2010. * Study conducted at Alergoskin Alergia e Dermatologia SS Ltda., Santo André, São Paulo, Brazil.
Paulo Ricardo Criado
Rua Carneiro Leão - 33, Vila Scarpelli
09.050-430 Santo André - SP, Brazil
Phone: +55 11 6255 1355
Conflict of interest: None
Financial funding: None
Approved by the Editorial Board and accepted for publication on 03.02.2010.
* Study conducted at Alergoskin Alergia e Dermatologia SS Ltda., Santo André, São Paulo, Brazil.