Кожные реакции на укусы насекомых

Тамразова О.Б., Стадникова А.С., Воробьева А.С. Кожные реакции на укусы насекомых. Педиатрия. Consilium Medicum. 2019; 3: 34–39.
DOI: 10.26442/26586630.2019.3.190554

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Tamrazova O.B., Stadnikova A.S., Vorob'eva A.S. Skin reactions to insect stings. Pediatrics. Consilium Medicum. 2019; 3: 34–39.
DOI: 10.26442/26586630.2019.3.190554

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Аннотация

Насекомые встречаются практически повсеместно, они способны распространяться на значительные расстояния не только путем активного перелета, но и за счет пассивного переноса с помощью ветра, а также посредством фиксации на кожных покровах животного или человека. В связи с этим вероятность укусов и контактов с насекомыми и продуктами их жизнедеятельности у человека весьма высока, что обусловливает повышенную степень риска сенсибилизации к аллергенам насекомых и служит причиной развития аллергической реакции. В России частота регистрации аллергической реакции на укусы насекомых колеблется от 0,1 до 0,4% в зависимости от региона. Наиболее часто в повседневной практике врачи-педиатры и дерматологи сталкиваются с развитием аллергической реакции на кровососущих насекомых. В статье описаны и проиллюстрированы типы аллергических реакций на укусы и контакты с насекомыми и продуктами их жизнедеятельности, приведена дифференциальная диагностика с патомимиями. Подробно изложены особенности клинической картины аллергических реакций на укусы кровососущих насекомых. Также в статье рассмотрены современные данные диагностики и лечения аллергических состояний, развившихся после контакта с насекомыми.
Ключевые слова: аллергическая реакция, насекомые, клиника, этиология, диагностика, лечение.

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Insects are found almost everywhere; they are able to spread over great lengths not only through active flight, but also due to passive transfer with the help of wind, as well as through fixation on the skin of an animal or person. To that end the likelihood of biting and contact with insects and products of their vital activity in humans is very high, which leads to an increased risk of sensitization to insect allergens and often causes an allergic reaction. In Russia, the frequency of registration of an allergic reaction to insect bites varies from 0.1 to 0.4%, depending on the region. Most often in everyday practice pediatricians and dermatologists meet the development of an allergic reaction to blood-sucking insects. The article describes and illustrates types of allergic reactions to bites and contact with insects and products of their vital activity, given the differential diagnosis with pathomimia. The features of the clinical picture of allergic reactions to bites of blood-sucking insects are described in detail. The article also discusses current data of diagnosis and treatment of allergic conditions that developed after contact with insects.
Key words: allergic reactions, insects, clinic, etiology, diagnosis, treatment.

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1.Shvets S.M. Allergicheskie reaktsii na iad zhaliashchikh nasekomykh. Ros. allergol. zhurn. 2004; 3: 9–18 (in Russian).
2. Tarasov V.V. Medical entomology. Moscow: MGU, 1996 (in Russian).
3. Engler RJ. Mosquito bite pathogenesis in necrotic skin reactors. Curr Opin Allergy Clin Immunol 2001; 1: 349.
4. Penneys NS, Nayar JK, Bernstein H, Knight JW. Chronic pruritic eruption in patients with acquired immunodeficiency syndrome associated with increased antibody titers to mosquito salivary gland antigens. J Am Acad Dermatol 1989; 21: 421.
5. Vassallo C, Passamonti F, Cananzi R et al. Exaggerated insect bite-like reaction in patients affected by oncohaematological diseases. Acta Derm Venereol 2005; 85: 76.
6. Wakimoto N, Niitsu N. Lymphoid neoplasms associated with mosquito bites. Intern Med 2005; 44: 1118.
7. Asada H. Hypersensitivity to mosquito bites: a unique pathogenic mechanism linking Epstein-Barr virus infection, allergy and oncogenesis. J Dermatol Sci 2007; 45: 153.
8. Smulevich A.B., Lvov A.N., Ivanov O.L. Pathomimia: the psychopathology of autoaggression in dermatological practice. Moscow: Meditsinskoe informatsionnoe agentstvo, 2012 (in Russian).
9. Demain JG. Papular urticaria and things that bite in the night. Curr Allergy Asthma Rep 2003; 3: 291.
10. Steen CJ, Carbonaro PA, Schwartz RA. Arthropods in dermatology. J Am Acad Dermatol 2004; 50: 819.
11. Hernandez RG, Cohen BA. Insect bite-induced hypersensitivity and the SCRATCH principles: a new approach to papular urticaria. Pediatrics 2006; 118: e189.
12. Frazier CA. Biting insects. Arch Dermatol 1973; 107: 400.
13. Vidal C, Armisén M, Bartolomé B et al. Anaphylaxis to Hippobosca equina (louse fly). Ann Allergy Asthma Immunol 2007; 99: 284.
14. Hrabak TM, Dice JP. Use of immunotherapy in the management of presumed anaphylaxis to the deer fly. Ann Allergy Asthma Immunol 2003; 90: 351.
15. Hassoun S, Drouet M, Sabbah A. Anaphylaxis caused by a mosquito: 2 case reports. Allerg Immunol (Paris) 1999; 31: 285.
16. Stevens WJ, Van den Abbeele J, Bridts CH. Anaphylactic reaction after bites by Glossina morsitans (tsetse fly) in a laboratory worker. J Allergy Clin Immunol 1996; 98: 700.
17. Decastello A, Farkas R. Anaphylactic reaction caused by a horse-fly species (Hippobosca equina). Orv Hetil 2009; 150: 1945.
18. Harada S, Yoshizaki Y, Natsuaki M et al. Three cases of centipede allergy–analysis of cross reactivity with bee allergy. Arerugi 2005; 54: 1279.
19. McCormack DR, Salata KF, Hershey JN, Carpenter GH. Mosquito anaphylaxis: Hyposensitization with whole body extracts. J Allergy Clin Immunol 1994; 93: 223.
20. Potier A, Lavigne C, Chappard D et al. Cutaneous manifestations in Hymenoptera and Diptera anaphylaxis: relationship with basal serum tryptase. Clin Exp Allergy 2009; 39: 717.
21. Reiter N, Reiter M, Altrichter S et al. Anaphylaxis caused by mosquito allergy in systemic mastocytosis. Lancet 2013; 382: 1380.
22. Kausar MA, Vijayan VK, Bansal SK et al. Mosquitoes as sources of inhalant allergens: clinicoimmunologic and biochemical studies. J Allergy Clin Immunol 2007; 120: 1219.
23.Bentsa T.M. Klinicheskaia immunologiia, allergologiia. Infektologiia. 2007; 6: 12–8 (in Russian).
24. Fradin MS. Mosquitoes and mosquito repellents: a clinician's guide. Ann Intern Med 1998; 128: 931.
25. Kulthanan K, Wongkamchai S, Triwongwaranat D. Mosquito allergy: clinical features and natural course. J Dermatol 2010; 37: 1025.
26. Manuyakorn W, Itsaradisaikul S, Benjaponpitak S et al. Mosquito allergy in children: Clinical features and limitation of commercially-available diagnostic tests. Asian Pac J Allergy Immunol 2017; 35: 186.
27. Simons FE, Peng Z. Skeeter syndrome. J Allergy Clin Immunol 1999; 104: 705.
28. Yoon TY, Kim YG, Kim JW, Kim MK. Nodal marginal zone lymphoma in association with hydroa vacciniforme-like papulovesicular eruption, hypersensitivity to mosquito bites and insect bite-like reaction. Br J Dermatol 2005; 153: 210.
29. Yamamoto T, Fujii K, Tsuji K et al. Characterization of Epstein-Barr virus-infected natural killer lymphocytes in a patient with hypersensitivity to mosquito bites. J Am Acad Dermatol 2005; 53: 912.
30. Cho JH, Kim HS, Ko YH, Park CS. Epstein-Barr virus infected natural killer cell lymphoma in a patient with hypersensitivity to mosquito bite. J Infect 2006; 52: e173.
31. Simons F, Estelle R. Histamine and H1-antihistamines: Celebrating a century of progress. J Allergy Clin Immunol 2011; 128 (6): 1139–50.e4.
32. Schaffler K, Wauschkuhn CH, Brunnauer H, Rehn D. Evaluation of the local anaesthetic activity of dimetindene maleate by means of laser algesimetry in healthy volunteers. Arzneimittelforschung 1992; 42 (11): 1332–5.
33.Gushchin G.I., Chitaeva V.G. Allergy to insects. Moscow: Farmarus Print, 2003; p. 8–85, 120–210 (in Russian).
34. Allergology. Clinical recommendations. Ed. R.M.Khaitova, N.I. Il'ina. Moscow, 2006; p. 21–3 (in Russian).
35. Palosuo T, Brummer-Korvenkontio H, Lappalainen P, Reunala T. Immune response to mosquito bites: Characterization of mosquito saliva specific antigens and antibodies by immunoblot technique. J Allergy Clin Immunol 1991; 87: 300.

Авторы

О.Б. Тамразова*1,2, А.С. Стадникова2, А.С. Воробьева2

1 ФГАОУ ВО «Российский университет дружбы народов» Министерства науки и высшего образования,
Москва, Россия;
2 ГБУЗ «Детская городская клиническая больница им. З.А. Башляевой» Департамента здравоохранения г. Москвы, Москва, Россия
*anait_tamrazova@mail.ru

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Olga B. Tamrazova*1,2, Antonina S. Stadnikova2, Aleksandra S. Vorob'eva2

1 People’s Friendship University of Russia, Moscow, Russia;
2 Baslyaeva Children's City Clinical Hospital, Moscow, Russia
*anait_tamrazova@mail.ru

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