Phlebotodermia
Phlebotodermia is a special dermatological disease in which the development of an acute inflammatory process occurs according to the type of dermatosis. The disease occurs as a result of saliva on the skin of mosquitoes after their bite, belonging to the genus phlebotomus.
The disease is considered to be quite widespread due to the natural conditions for the life of phlebotomuses. Phlebotodermia is characteristic of countries with a hot, humid climate, for example, in the Middle East or Central Asian countries.
Phlebotodermia, which occurs in an unusual climate for the disease, has characteristic features – namely, a tendency to seasonal exacerbation of cases of the disease. In endemic countries, the disease is common all year round.
Synonyms of the disease are also – mosquito dermatosis.
ETIOLOGY AND PATHOGENESIS
The main cause of the disease is the development of a toxic and toxic–allergic reaction to the contact of the saliva of a mosquito of the genus phlebotomus with human skin during insect bites. Only females who commit acts of blood-sucking immediately before laying eggs are dangerous to humans.
The disease has some predisposing factors: a history of parasitic diseases, especially characteristic of hot countries, as well as diseases such as malaria, other worm infestations.
As a result of the contact of mosquito saliva with the skin, the following is found on the skin surface: hyperkeratosis, acanthosis. Histological examination of the dermis reveals dystrophy of elastic and collagen fibers, hyperplasia of nerve cells, infiltration by fibroplasts.
The disease can occur both acutely and go into a chronic form. The duration of the disease can be from several months to several years.
SYMPTOMS OF PHLEBOTODERMIA
The disease begins acutely, the first manifestations develop a few minutes after the bite. The skin at the site of the bite becomes hyperemic, a blister or papule appears, accompanied by severe itching. Sometimes the reaction may be somewhat delayed, but in this case the reaction is manifested by swelling and burning sensations. Usually, immediate reactions take place after a certain period of time, but if the reaction did not occur immediately, it has a longer stability.
Further, as the disease develops, papules with swelling appear on the skin at the site of the rash on open areas of the skin – the face, shins, forearms, on the back of the hands. The rash itches, burns. In repeated cases, the erupting papules thicken, take on the appearance of nodes, itching and other negative sensations increase.
The general condition of the patient has not changed, but sometimes there are general reactions of the body – increased body temperature, malaise and general weakness. After a while, the nodule or papule begins to dissolve and turn pale.
In some patients, the disease takes the form of a serious and dangerous allergic condition – Quincke’s edema. Also, rashes can take on a more intimidating appearance – cases of bullous rash are not uncommon. Bulla is a bubble. This form of the disease is most often found in allergy sufferers.
With the development of complications, the following symptoms may appear:
The addition of secondary infection and the development of pustular infection.
In the case of mosquito–borne pathogens of infectious diseases, the development of leishmaniasis, arbovirus infections, bartonellosis is possible.
TREATMENT OF THE DISEASE
There is no etiotropic treatment aimed at mosquito activity. The main activities that are carried out are aimed at relieving already developed symptoms.
For this purpose, local and general means are used. General therapy includes taking antihistamines. In some cases, aminazine is indicated. In severe cases, with the development of dangerous conditions, the use of systemic glucocorticosteroids is indicated.
Also, the patient should avoid visiting places where there is an increased number of various insects and mosquitoes to reduce the sensitization of the body to saliva secreted by mosquitoes.
