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.

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 September 23, 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 September 23, 2014).

Share This



More Health & Medicine News

Tuesday, September 23, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Liberia Pleads for Help to Fight Ebola

Liberia Pleads for Help to Fight Ebola

AP (Sep. 22, 2014) Liberia's finance minister is urging the international community to quickly follow through on pledges of cash to battle Ebola. Bodies are piling up in the capital Monrovia as the nation awaits more help. (Sept. 22) Video provided by AP
Powered by NewsLook.com
Ebola Doctor Says Border Controls Critical

Ebola Doctor Says Border Controls Critical

AP (Sep. 22, 2014) A Florida doctor who helped fight the expanding Ebola outbreak in West Africa says the disease can be stopped, but only if nations quickly step up their response and make border control a priority. (Sept. 22) Video provided by AP
Powered by NewsLook.com
Global Ebola Aid Increasing But Critics Say It's Late

Global Ebola Aid Increasing But Critics Say It's Late

Newsy (Sep. 21, 2014) More than 100 tons of medical supplies were sent to West Africa on Saturday, but aid workers say the global response is still sluggish. Video provided by Newsy
Powered by NewsLook.com
Sierra Leone in Lockdown to Control Ebola

Sierra Leone in Lockdown to Control Ebola

AP (Sep. 21, 2014) Sierra Leone residents remained in lockdown on Saturday as part of a massive effort to confine millions of people to their homes in a bid to stem the biggest Ebola outbreak in history. (Sept. 20) Video provided by AP
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