Dermatologic therapy
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Cimex lectularius (the "bedbug") is an insect that feeds nocturnally, taking a requisite blood meal from a sleeping human or other parasitized host. Immunological reactions to bedbug saliva vary, but typically, bites yield erythematous and pruritic papules. The face and distal extremities, areas uncovered by sleeping clothes or blankets, are preferentially involved. ⋯ Although hepatitis or human immunodeficiency virus is not effectively transmitted by the bedbug, pruritus and the fear and perceived violation of an infestation can be debilitating. Bedbugs are small but robust, and their ability to remain ensconced in crevices within the bedroom makes eradication difficult. As more patients present with bedbug bites, physicians must possess the knowledge to diagnose, treat, and educate with regard to bedbug bites and bedbug infestations.
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Lepidoptera (moths, butterflies, and caterpillars) are an uncommon cause of adverse reactions in humans. Most reactions to Lepidoptera are mild and self-limited; however, reactions in sensitive individuals and reactions to particular species can be severe and life threatening. ⋯ Antipruritic or anesthetic topical preparations, topical steroids, and oral antihistamines are often used. In the case of potentially fatal Lonomia envenomation, an effective antivenin has been manufactured.