These small, pruritic papules appeared in the morning, which strongly suggests the bite of a nocturnal feeding arthropod. Insect bites arranged in clusters of 3 is typical for, but not diagnostic of, bedbug infestation.
A 56-year-old woman complained about a cluster of “itchy bumps” on her arms and legs. Every morning, she would awake to see a new set of similar lesions.
Key point: These small, pruritic papules are classic for insect bites. The fact that they appear in the morning, strongly suggests the bite of a nocturnal feeding arthropod.
Treatment: Individual lesions resolved quickly after application of a mid-potency corticosteroid ointment. The patient was advised to call a professional exterminator to survey for and eliminate the causative insect infestation. Bedbugs were found, and the infestation remediated.
Note: Insect bites arranged in clusters of 3 is typical for, but not diagnostic of, bedbug infestation.
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