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Correspondence |

Effects of Bed Bug Saliva on Human Skin

Jerome Goddard, PhD; Kristine T. Edwards, DVM, PhD
JAMA Dermatol. 2013;149(3):372-373. doi:10.1001/jamadermatol.2013.878.
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Bed bug infestations are increasing in scope, frequency, and geographic distribution worldwide, and bed bug bites should be included in the differential diagnosis in cases of unexplained or cryptic insect bites and anaphylactoid reactions.14 Some patients apparently develop sensitivity to bed bug bites, while others do not.5,6 The nature, type, and location of allergens in bed bugs causing dermatologic reactions in humans have not been elucidated. Presumably, bed bug allergens are located in the saliva. With appropriate institutional review board approval, we tested that hypothesis, feeding bed bugs, both with and without intact salivary glands, on a volunteer known to react to the bites.

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saliva ; bedbugs

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Figure. Clinical images of study volunteer's arms used for testing of bed bug bites. A, Left arm, bed bugs with and without salivary glands feeding. B, Left arm, 2 days post bite; arrows point to erythema at bite site of bed bugs with salivary glands intact. C, Right arm, 4 days post bite, arrows point to bite reaction to bed bugs with salivary glands intact. D, Direct application of bandages treated with phosphate-buffered saline (PBS) (bandage A) and bed bug saliva (bandage B). E, Arm with topically applied PBS and bed bug saliva after bandage removal; pen points to raised pruritic lesion from saliva 72 hours post application.




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The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
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Effects of bed bug saliva on human skin. JAMA Dermatol 2013;149(3):372-3.