Immunology and treatment of mosquito bites

Summary Cutaneous reactions to mosquito bites are usually pruritic weals and delayed papules. Arthus‐type local and systemic symptoms can also occur but anaphylactic reactions are very rare. Both clinical and experimental evidence suggest that the various bite reactions result from sensitization to the mosquito saliva injected into the skin during feeding. Recent immunoblot studies have shown both IgG‐ and IgE‐class anti‐mosquito antibodies, but their species‐specificity and clinical importance is at present unknown. In addition to an Arthus‐type mechanism, both cutaneous late‐phase reactivity and cell‐mediated immunity may be involved in the pathophysiology of delayed mosquito‐bite lesions. Cutaneous sensitization to mosquito bites can be divided into five different stages ranging from the stages of immediate wealing and delayed bite papules, to the stage of non‐reactivity. No desensitization treatment is generally available for mosquito allergy but it has recently been shown that cetirizine, a potent non‐sedating antihistamine, is effective against the wealing and pruritus caused by mosquito bites.