Question 1

Exotic insects bites consequences

Accepted Answer

A 34-year-old woman was bitten by local insects while traveling in Asia. The bites did not cause much discomfort and she did not attach any importance to them. Soon the bites were gone without a trace. After returning home, repeated rashes were noted at the bite sites. The use of cortisone cream quickly relieved itching and swelling. The patient is concerned about unusual allergic manifestations.

Available data: laboratory blood test, including immunoglobulin, general and biochemical tests; photos of skin rashes.

Problem statement

Is the treatment of late rash different from the treatment of the bites themselves?
Can exotic insect bites have long-term consequences?

Selected Format

Written consultation

Outcome

Medconsonline contacted a dermatologist who requested advanced laboratory diagnostics: metabolic parameters, visceral and thyroid function, results of allergic PRIC testing.
After analyzing the results of laboratory tests and photographs of skin rashes, the doctor concluded that the patient had no signs of a predisposition to allergies. The response to corticosteroid treatment was adequate. Consultation with a specialist in tropical diseases was recommended to exclude chronic infection.
The Tropical Diseases Specialist requested additional laboratory testing (viral serology and a wide range of inflammatory markers, including at the cellular level). It was not possible to conduct all the necessary studies in the patient's home country. She visited Germany and conducted examinations in a specialized clinic for tropical medicine. Diagnostic results showed no infection. Specialized diagnostics was also recommended to exclude possible parasitic invasion.

Medconsonline comment

The consultation purpose was to rule out a bacterial infection that could cause long-term effects. The patient also received recommendations that helped to identify the cause of the complaints.

Consulting expert

Tom Luedde

Professor, Dr. med., Head of the Clinic of Gastroenterology, Hepatology and Infectious Diseases, University Hospital Dusseldorf

Question 2

Increased photosensitivity: prevention measures

Accepted Answer

A 50-year-old patient complains of an itchy skin rash that appears even after short exposure to the sun.
Available data: photodography of the affected skin areas, microbiological study of the skin, which did not reveal a fungal infection.

Problem statement

Ways to prevent hypertrophic skin reaction to sunlight

Selected Format

A written consultation. The format has been changed to a video consultation at the request of a doctor.

Outcome

The consultation was conducted by a doctor of a specialized dermatological clinic. The consultant requested a video consultation to personally determine the patient's skin type and ask clarifying questions about the course of the disease. As a result of the consultation, it was determined that the patient has the lightest, "Celtic", skin type, which is characterized by increased sensitivity to sunlight. The main complaints were associated with this factor.
The patient received general recommendations to carry out Light hardening, apply a high-quality sunscreen with a factor of 50-100 even on cloudy days. Medicines and cosmetics were prescribed. A cream was prescribed that not only weakens the action of ultraviolet rays of type A and B, but also increases the protective mechanisms and skin resistance. When a rash appears, it is recommended to use pharmaceutical milk, which has a calming effect on the solar allergy areas. Therapy may be supplemented with an antihistamine.

Medconsonline Comment

As a result of the remote consultation, the patient received general recommendations for the prevention of solar allergies and a drug therapy plan.

Consulting expert

Said Hilton

Dr. Med., Founder and head of the largest private dermatology, venereal and allergy clinic in North Rhine-Westphalia. Specialist in the field of aesthetic medicine

Allergology