Insect bite reaction

Case 144   Dec 2010 (P. McKee) – shows flame figure 

DD: drug reaction; fungal infection with Splendore-Hoeppli phenomenon; 

Wells’ syndrome 

Case 537   June 2012 (? Contributor)  M  70 juicy nodules on back 

Intense nodular lymphocytic infiltrate with prominent eos.  Epidermal pallor. 

Case 609   9.10.12  (P.McKee) F 18 oedematous nodule, face 

Pseudo-lymphomatous pattern with eos. 

Case 922  3.1.14 (R. Carr)  F 75 persistent itchy plaques on back 

Scabies nodule (persistent insect bite reaction) 

Dense lympho-eosinophilic infiltrate in superficial and mid-dermis.  Incipient blistering.  Infiltrate thought to be too dense for the pre-bullous phase of pemphigoid. 

Case 1748   8.2.17 (H. Diwan)  F 46 arm 

Nodular infiltrate with prominent eosinophils.  Interstitial mucin (patient also had lupus) 

Case 2185  24.10.18  (H. Diwan) F 23 multiple nodules on arm 

Nodular dermal lymphocytic infiltrate with prominent eosinophils.  Very little endothelial change.  I don’t agree with given diagnosis of ALHE. 

Case 2110  9.7.18  (L. Yu)  F  45 lesion flank 

Marked papillary vesicle formation.  Tight perivascular lymphocytic infiltrate.  ? some eos (not v. obvious).  I was thinking of acute cold injury. 

Case 2811  15.4.21 (S. Taibjee) F 5 itchy papules on an urticated base with vesicles 

Rather interstitial pattern of inflammation with prominent eosinophils and flame figures.  Focus of epidermal disruption perhaps a clue to exogenous bite rather than scabies. 

Case 2869  6.7.21 (IH Chaudhry)  M 60 nodule, back 

Jessner-like pattern but heterogeneous cell population including plasmacytoid cells.  Concluded pseudo-lymphoma secondary to insect bite.