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Superficial lymphangitis after arthropod bite: a distinctive but underrecognized entity?

Myriam Marque¹, Céline Girard, Bernard Guillot

¹Department of Dermatology, CHU of Montpellier, Montpellier University 1, Montpellier, France. myriammarque@yahoo.fr

Dermatology (Basel, Switzerland)

|August 8, 2008

Summary

Noninfectious superficial lymphangitis after arthropod bites presents as red streaks mimicking bacterial infections. This study highlights its distinct features, differentiating it from bacterial lymphangitis to prevent unnecessary antibiotic use.

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Area of Science:

Dermatology
Pathology
Immunohistochemistry

Background:

Acute bacterial lymphangitis is commonly diagnosed after skin damage, often presenting as red linear streaks following arthropod bites.
This frequently leads to the prescription of oral antibiotics, even when the cause may be noninfectious.
Noninfectious superficial lymphangitis post-arthropod bite is an underrecognized condition posing a diagnostic challenge.

Observation:

The study investigated six patients with an acute, linear, erythematous eruption along lymphatic vessels between 2003 and 2006.
These clinical presentations mimicked typical bacterial lymphangitis.
Histopathological examinations, including D2-40 immunolabeling, were performed.

Findings:

Clinical and histological findings definitively excluded an infectious etiology in all observed cases.
The results strongly suggested noninfectious superficial lymphangitis following an arthropod bite.
Immunohistochemistry using D2-40 confirmed lymphatic endothelial involvement.

Implications:

This research clarifies the clinical and histological characteristics of noninfectious superficial lymphangitis after arthropod bites.
Awareness of this benign condition can prevent the unnecessary prescription of antibiotics.
Accurate diagnosis avoids overtreatment and potential antibiotic resistance development.