Again, it s a delayed hypersensitivity reaction to the flea bite. You ve got to have them for awhile, you ve got to get allergic to them. You get multiple hemorrhagic papules, they get indurated, they get urticarial and you can even have blisters if somebody is allergic to them. You can also get papular urticaria from flea bites. So when the mother brings in the child and it looks like 800 bites, it could be that they are getting flea bites every once in awhile and they are having the papular urticarial response and the other three children aren t.
Secondary infection is common.
The main concern is trying to eliminate it. You treat it, of course, with antihistamines, topical steroids, sometimes antibiotics. The main thing though is the suggestion of when you make this diagnosis. One is a child with multiple pruritic lesions on the legs and the history of a new dog or a cat. So when you The other thing is, in an adult or in children with multiple pruritic lesions of the legs and the history of a recent habitation in a house or apartment that used to have a cat or a dog, you know the fleas stay around.