Featured Research

from universities, journals, and other organizations

Hopkins Researchers Develop New Quick Tool To Sort Out Insect Bites In Children

Date:
June 28, 2006
Source:
Johns Hopkins Medical Institutions
Summary:
Children afflicted with insect-bite rashes are often misdiagnosed or referred for extensive and costly tests, but a new, easy-to-remember set of guidelines developed at the Johns Hopkins Children's Center should help.

Children afflicted with insect-bite rashes are often misdiagnosed or referred for extensive and costly tests, but a new, easy-to-remember set of guidelines developed at the Johns Hopkins Children's Center should help.

Related Articles


Called SCRATCH, the letters form a memorable acronym for symmetry, cluster, Rover, age, target/time, confused, household). It is a guide to the symptoms and features that help pediatricians and others to recognize the source of a rash.

Insect-bite skin rashes mimic the symptoms of a variety of conditions, ranging from fungal infections, scabies, allergies and environmental contacts, to HIV-associated dermatoses. Reactions to a bite are often delayed, making it difficult to trace exposure.

"SCRATCH could spare many children and their parents from going through invasive-not to mention expensive-procedures if pediatricians recognize the problem early on," says Raquel Hernandez, M.D., a third-year resident at the Children's Center and lead author of the article, published in the July online edition of Pediatrics.

Hernandez and co-author Bernard Cohen, M.D., head of dermatology at the Children's Center, developed SCRATCH by examining a month's worth of patient records from visits to the Children's Center dermatology clinic. They found that the majority of children who were eventually diagnosed with an insect-bite rash had undergone extensive lab tests and skin biopsies before they were referred to Hopkins.

The most common misdiagnosis was scabies, a skin infection caused by a parasite that produces red, itchy lesions. Many of the children were treated repeatedly for scabies.

"These guidelines are really intended to make pediatricians consider insect-bite hypersensitivity as a diagnosis and think twice before referring a child for a skin biopsy or another invasive procedure," Cohen says.
Using the tool is straightforward, Cohen adds. If the rash fits the SCRATCH criteria, it's likely bug-borne.

S for Symmetry
Erruptions are usually symmetric and appear on exposed parts of the body, such as face, neck, arms, legs. Younger children may have rashes on their scalps. Diaper areas, palms and soles are not affected. The trunk is rarely affected. By contrast, scabies causes rashes on palms, soles and between toes and fingers.

C for Clusters
Lesions appear in "meal clusters," described as breakfast, lunch and dinner. The linear or triangular clusters are typical of bedbug bites, but also appear in bites caused by fleas.

R for Rover Not Required
Presence of pets in the household is not a criterion for diagnosis because a bite might occur outside of the home.

A for Age Specific
The condition is most prevalent in children between the ages of 2 and 10.

T for Target Lesions and Time
Target-shaped lesions - named so for their resemblance to the bull's eye on a target -- are typical of insect-bite hypersensitivity. Time indicates the chronic/recurrent nature of the eruptions. Many patients may have delayed reactions and may not experience flareups until months or years after the intial exposure. Most children develop full immunity by age 10 and no longer have recurrent rashes.

C for Confusion
Parents often express confusion and disbelief at the suggestion that there might be fleas or bedbugs in their homes. "One of the primary criteria is that if the parents don't believe me, I am probably right," Cohen says.

H for Household with Single Family Member Affected
Unlike conditions that have similar symptoms, such as scabies and atopic dermatitis, insect-bite rashes often appear in a single member in a family.

"Common sense might tell us that fleas and mosquitoes would affect other members of the family, but we must keep in mind that these rashes develop in children who have hypersensitivity that others do not have," Hernandez said.


Story Source:

The above story is based on materials provided by Johns Hopkins Medical Institutions. Note: Materials may be edited for content and length.


Cite This Page:

Johns Hopkins Medical Institutions. "Hopkins Researchers Develop New Quick Tool To Sort Out Insect Bites In Children." ScienceDaily. ScienceDaily, 28 June 2006. <www.sciencedaily.com/releases/2006/06/060628234124.htm>.
Johns Hopkins Medical Institutions. (2006, June 28). Hopkins Researchers Develop New Quick Tool To Sort Out Insect Bites In Children. ScienceDaily. Retrieved November 24, 2014 from www.sciencedaily.com/releases/2006/06/060628234124.htm
Johns Hopkins Medical Institutions. "Hopkins Researchers Develop New Quick Tool To Sort Out Insect Bites In Children." ScienceDaily. www.sciencedaily.com/releases/2006/06/060628234124.htm (accessed November 24, 2014).

Share This


More From ScienceDaily



More Health & Medicine News

Monday, November 24, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Are Female Bosses More Likely To Be Depressed?

Are Female Bosses More Likely To Be Depressed?

Newsy (Nov. 24, 2014) A new study links greater authority with increased depressive symptoms among women in the workplace. Video provided by Newsy
Powered by NewsLook.com
Winter Can Cause Depression — Here's How To Combat It

Winter Can Cause Depression — Here's How To Combat It

Newsy (Nov. 23, 2014) Millions of American suffer from seasonal depression every year. It can lead to adverse health effects, but there are ways to ease symptoms. Video provided by Newsy
Powered by NewsLook.com
Ebola-Hit Sierra Leone's Late Cocoa Leaves Bitter Taste

Ebola-Hit Sierra Leone's Late Cocoa Leaves Bitter Taste

AFP (Nov. 23, 2014) The arable district of Kenema in Sierra Leone -- at the centre of the Ebola outbreak in May -- has been under quarantine for three months as the cocoa harvest comes in. Duration: 01:32 Video provided by AFP
Powered by NewsLook.com
Don't Fall For Flu Shot Myths

Don't Fall For Flu Shot Myths

Newsy (Nov. 23, 2014) Misconceptions abound when it comes to your annual flu shot. Medical experts say most people older than 6 months should get the shot. Video provided by Newsy
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:

Strange & Offbeat Stories


Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins