Cimicose T00.9

Author: Prof. Dr. med. Peter Altmeyer

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Last updated on: 07.10.2021

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Synonym(s)

Bedbug bites; Bedbugs; cimex lectularis; Cimicosis; Pigeon bugs

Definition
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Skin symptoms caused by stings of bloodsucking bugs(Cimex lectularis/bed bugs, Cimex columbarius/pigeon bugs, very rare - Oeciacus hirundinis/swallow bugs), which are very itchy. Nowadays it is increasingly common again in Germany.

Etiopathogenesis
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Bedbugs nest mainly in dark cracks in furniture, walls, behind pictures in neglected rooms and seek out people at night, e.g. by falling from the ceiling. The saliva secretion injected with the bite causes an initially urticarial, later papular skin reaction.

Localization
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Uncovered body parts.

Clinical features
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Grouped (footprint-like linear stitches - the pests do not always hit a blood vessel during the first stings so that they continue to migrate), up to 0.5 cm large, intensely itchy, bright red wheals, papules or plaques with a central, punctate, haemorrhagic sting. In the course of days, transformation into more indurated papules or plaques, which continue to itch to varying degrees, and possibly blistering. Occasionally pustules also develop. Nitrophorin, which is present in bug saliva, seems to be an important allergen.

Phenomenon of repetition: co-reaction of old lesions with the appearance of new bites. Decrease in intensity of skin manifestations with repeated infestations.

The skin lesions may persist for up to 10 days.

Differential diagnosis
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Flea bites (covered skin areas).

Therapy
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Locally with lotio alba or, if necessary, glucocorticoids such as triamcinolone cream R259, in cases of severe perioral pruritus, antihistamines such as desloratadine (e.g. Aerius 1-2 tbl/day p.o.).

General therapy
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Restoration of the infested rooms with the help of insecticides(permethrin, malathion, pyriproxyfen, pyrethrin), if necessary removal of niches (loose wallpaper, wooden ceilings), restoration by exterminators

Literature
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  1. Arayesh A et al (2013) Itching and urticarial inflammatory reaction of the skin of unclear etiology. Dermatologist 64: 187-189
  2. Beck W (2017) Infestation with bedbugs by Cimex lectularis and Cimex columbarius. Derm 23: 362-366

Disclaimer

Please ask your physician for a reliable diagnosis. This website is only meant as a reference.

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Last updated on: 07.10.2021