Mosquitoes, ticks, fleas, and bed bugs suck blood, while bees, hornets, centipedes, spiders, and ants sting or bite. Once saliva of those insects penetrate through the skin, allergic reaction occur and swelling, itch, and pain may come next.
The first choice management includes topical steroid, and oral anti-histamines may be prescribed when needed. If the swelling is severe, gauze with liquid acrinol solution may be applied. If there is simultaneous bacterial infection, such as impetigo and subcutaneous abscess, systemic antibiotics is needed. Anaphylactic shock occur within 30 minutes after a bee/hornet sting and over 10 people dies every year in Japan. If a patient has an experience of severe swelling after a bee/hornet sting, the self-injection kit of adrenaline can be prescribed to avoid anaphlacitic shock by the second time bee/hornet sting.