Hernandez Raquel G, Cohen Bernard A
Department of Pediatrics, Johns Hopkins Hospital, CMSC 217, 600 N Wolfe St, Baltimore, Maryland 21287, USA.
Pediatrics. 2006 Jul;118(1):e189-96. doi: 10.1542/peds.2005-2550. Epub 2006 Jun 2.
Insect bites and the associated hypersensitivity reactions known as papular urticaria account for a significant number of all referrals from pediatricians and dermatologists to our pediatric dermatology clinic. Unfortunately, children affected by these eruptions are frequently misdiagnosed and often subject to expensive evaluations including invasive and unnecessary procedures. Here we review the course of 4 children with the typical physical findings and natural history of these reactions. On the basis of our clinical findings and experience with this patient population, we propose a set of principles (termed "SCRATCH") as clinical features to aid clinicians in making an early and accurate clinical diagnosis. We conclude that a more appropriate term for future study and diagnosis of this entity is insect bite-induced hypersensitivity.
昆虫叮咬以及与之相关的被称为丘疹性荨麻疹的超敏反应，在儿科医生和皮肤科医生转诊至我们儿科皮肤科诊所的所有病例中占相当大的比例。不幸的是，受这些皮疹影响的儿童经常被误诊，并且常常接受包括侵入性和不必要的检查在内的昂贵评估。在此，我们回顾了4例具有这些反应典型体格检查结果和自然病程的儿童病例。基于我们对该患者群体的临床发现和经验，我们提出了一组原则（称为“SCRATCH”）作为临床特征，以帮助临床医生进行早期准确的临床诊断。我们得出结论，对于该病症未来的研究和诊断，更合适的术语是昆虫叮咬诱发的超敏反应。
