{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T19:30:08Z","timestamp":1789500608316,"version":"build-2803163510"},"reference-count":13,"publisher":"American Academy of Pediatrics (AAP)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2006,7,1]]},"abstract":"<jats:p>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 \u201cSCRATCH\u201d) 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\u2013induced hypersensitivity.<\/jats:p>","DOI":"10.1542\/peds.2005-2550","type":"journal-article","created":{"date-parts":[[2006,6,3]],"date-time":"2006-06-03T00:59:25Z","timestamp":1149296365000},"page":"e189-e196","source":"Crossref","is-referenced-by-count":41,"title":["Insect Bite\u2013Induced Hypersensitivity and the SCRATCH Principles: A New Approach to Papular Urticaria"],"prefix":"10.1542","volume":"118","author":[{"given":"Raquel G.","family":"Hernandez","sequence":"first","affiliation":[{"name":"Pediatrics"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernard A.","family":"Cohen","sequence":"additional","affiliation":[{"name":"Pediatric Dermatology, Johns Hopkins Hospital, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2006,7,1]]},"reference":[{"key":"2021120823063505000_R1","doi-asserted-by":"crossref","unstructured":"Demain JG. Papular urticaria and things that bite in the night. Curr Allergy Asthma Rep.\u20082003;3:291\u2013303","DOI":"10.1007\/s11882-003-0089-3"},{"key":"2021120823063505000_R2","doi-asserted-by":"crossref","unstructured":"Steen CJ, Carbonaro PA, Schwartz RA. Arthropods in dermatology. J Am Acad Dermatol.\u20082004;50:819\u2013862","DOI":"10.1016\/j.jaad.2003.12.019"},{"key":"2021120823063505000_R3","doi-asserted-by":"crossref","unstructured":"Cohen B. Pediatric Dermatology. Baltimore, MD: Elsevier Inc; 2005","DOI":"10.1016\/B978-0-323-02363-4.50007-0"},{"key":"2021120823063505000_R4","unstructured":"Maunder JW. Papular urticaria. In: Harper J, Oranje A, Prose N. eds. Textbook of Pediatric Dermatology. London, England: Blackwell Science; 2000:549\u2013554"},{"key":"2021120823063505000_R5","doi-asserted-by":"crossref","unstructured":"Arlian L. Arthropod allergens and human health. Annu Rev Entomol.\u20082002;47:395\u2013433","DOI":"10.1146\/annurev.ento.47.091201.145224"},{"key":"2021120823063505000_R6","doi-asserted-by":"crossref","unstructured":"Hwang S, Svoboda TJ, DeJong I, Kabesele K, Gogosis E. Bed bug infestations in an urban environment. Emerg Infect Dis.\u20082005;11:533\u2013538","DOI":"10.3201\/eid1104.041126"},{"key":"2021120823063505000_R7","unstructured":"Owen J. Bloodthirsty bedbugs stage comeback in U.S., Europe. National Geographic News [serial online]. May 13, 2004. Available at: http:\/\/news.nationalgeographic.com\/news\/2004\/05\/0513_040513_bedbugs.html. Accessed April 28, 2006"},{"key":"2021120823063505000_R8","doi-asserted-by":"crossref","unstructured":"Cleary C, Buchanan D. Diagnosis and management of bedbugs: an emerging US infestation. Nurse Pract.\u20082004;29(6):46\u201348","DOI":"10.1097\/00006205-200406000-00009"},{"key":"2021120823063505000_R9","unstructured":"Weedon D. Skin Pathology. Edinburgh, Scotland: Elsevier Science; 2002"},{"key":"2021120823063505000_R10","doi-asserted-by":"crossref","unstructured":"Feingold BF, Benjamini E, Michaeli D. The allergic responses to insect bites. Annu Rev Entomol.\u20081968;13:137\u2013158","DOI":"10.1146\/annurev.en.13.010168.001033"},{"key":"2021120823063505000_R11","doi-asserted-by":"crossref","unstructured":"Jordaan HF, Schneider JW. Papular urticaria: a histopathologic study of 30 patients. Am J Dermatopathol.\u20081997;19:119\u2013126","DOI":"10.1097\/00000372-199704000-00004"},{"key":"2021120823063505000_R12","doi-asserted-by":"crossref","unstructured":"Garcia E, Halpert E, Rodriguez A, Andrade R, Fiorentino S, Garcia C. Immune and histopathologic examination of flea-bite induced papular urticaria. Ann Allergy Asthma Immunol.\u20082004;92:446\u2013452","DOI":"10.1016\/S1081-1206(10)61781-4"},{"key":"2021120823063505000_R13","unstructured":"Wright GE. Domestic pet infestations and papular urticaria. Practitioner.\u20081972;208:406\u2013411"}],"container-title":["Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/118\/1\/e189\/1011295\/zpe0070600e189.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/118\/1\/e189\/1011295\/zpe0070600e189.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,12,9]],"date-time":"2021-12-09T03:04:27Z","timestamp":1639019067000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.aap.org\/pediatrics\/article\/118\/1\/e189\/69596\/Insect-Bite-Induced-Hypersensitivity-and-the"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2006,7,1]]},"references-count":13,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2006,7,1]]},"published-print":{"date-parts":[[2006,7,1]]}},"URL":"https:\/\/doi.org\/10.1542\/peds.2005-2550","relation":{},"ISSN":["0031-4005","1098-4275"],"issn-type":[{"value":"0031-4005","type":"print"},{"value":"1098-4275","type":"electronic"}],"subject":[],"published":{"date-parts":[[2006,7,1]]}}}