Difference Between Hives and Bug Bites

Skin manifestations and changes are the usual things that we see after an insect bite. The most common thing that happens is the appearance of erythematous, bumpy lesions  on the skin which are itchy most of the time. These lesions are called the hives or urticaria. Accordingly, hives themselves are not a disease but are a manifestation of an underlying pathological change that takes place within the body. Likewise, hives appear as a manifestation in bug bites also. This is the key difference between hives and bug bites.

CONTENTS

1. Overview and Key Difference
2. What are Hives
3. What are Bug Bites
4. Side by Side Comparison – Hives vs Bug Bites in Tabular Form
5. Summary

What are Hives (Urticaria)?

The sudden appearance of erythematous and edematous bump like lesions on the skin is known as hives or urticaria.

These lesions can appear anywhere on the skin and can give rise to pruritus or a burning sensation. The size of hives varies, but on some occasions, they can merge to form larger lesions called the plaques. Usually, hives are a self-limiting condition where the individual lesions disappear within a day. Despite the disappearance of already existing lesions new ones continue to appear depending on the underlying aetiology.

Causes

The release of histamine plays a key role in the pathogenesis of urticarial rashes.

• Allergic and hypersensitivity reactions
• Adverse effects of various drugs such as NSAIDS and ACE inhibitors

The variety of hives lasting for less than six weeks is called the acute hives. If it lasts for more than six weeks that is identified as chronic hives.

Main Types of Urticaria

There is a variant of urticaria called the angioedema that predominantly affects the subcutaneous tissues. Therefore, the erythema and the concomitant edema are less pronounced.

Investigations

A good clinical history is usually sufficient to identify the underlying disease.But in case of an abnormal presentation following tests can be performed.

• ESR
• CRP
• RAST
• Chest X-ray

Treatment

The management of urticaria varies according to the aetiology. The common measures and procedures followed in treating this condition includes

• Avoiding the exposure to allergens and environmental conditions that trigger urticaria
• Use of antihistamines
• Wearing protective clothing

What are Bug Bites?

Been bitten by a bug is a common thing that happens so often in our daily life. But for some people, this can give some troublesome symptoms, and occasionally hospitalisations are also required.

Clinical Features of Bug Bites

• Minor swelling at the site of bite
• Mild pain
• Itching

In most of the cases, these symptoms last for only a few hours.

Rarely people can develop anaphylactic reactions which are characterised by the following clinical features.

• Cough and wheezing
• Dyspnea
• Swelling of the face, lips, etc.
• Nausea and diarrhoea
• Appearance of hives and erythema on the skin

Medical attention is required only when the patient develops signs of anaphylactic shock that are mentioned above.

What is the Difference Between Hives and Bug Bites?

Summary – Hives vs Bug Bites 

Bug bites can give rise to hives which are erythematous and edematous bump like lesions on the skin. Accordingly, hives are a manifestation of bug bites and not a disease themselves. This can be highlighted as the difference between hives and bug bites.

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Reference:

1.Buxton, Paul K. ABC of dermatology. London: BMJ, 2007

Image Courtesy:

1.’Urticaria’By BruceBlaus – Own work, (CC BY-SA 4.0) via Commons Wikimedia
2.’Bedbugb1’By James Heilman, MD – Own work, (CC BY-SA 3.0) via Commons Wikimedia