The cause of bite can often be readily diagnosed where insect remains attached as in ticks and with bloodsuckers that are highly visible, e.g. mosquitoes, midges and black flies. Others may not be so easy to diagnose because they bite at night or when patient is asleep, e.g. some mosquitoes, sandflies, bedbugs, triatomine bugs or when it is inconspicuous and does not cause an immediate painful bite, e.g. harvest mites, some fleas and biting flies. Bites typically result in single or grouped pruritic erythematous papules. Some may have a central punctum and others may be bullous.
There is often a skin reaction to an insect bite, and this may lead to pruritus and urticarial papules, and sometimes leads to secondary bacterial infection. As well as a local reaction, the bite may cause an anaphylactic reaction and may act as a vector of disease.
General management measures include cooling the skin, calamine and antihistamines to reduce itching, antibiotics for secondary bacterial infection if develops, and any specific treatment for disease transmitted as a result of the bite.
