It is fall again. If
the temperatures haven't started to drop yet where you live, they likely will
soon. It is time to break out the sweaters, jackets, coats, sweatshirts and
warmer sheets, blankets and comforters. It is also prime time for dust
Usually around this
time of year I see an influx of patients presenting to the office complaining
of new onset itching and redness primarily to the neck, intertriginous areas
and waist/trunk. As a young practitioner, this perplexed me and I would biopsy
these rashes and they would invariably come back as being consistent with an
arthropod assault. Not to age myself, but this pre-dated the time when everyone
became aware of the bed bugs and dust mites in hotels that caused such a stir a
few years ago.
What was happening with
my patients is that they would take the warmer clothes and blankets off the
shelf in the closet and wear them without washing them first. The dust that had
accumulated in the closets and on the clothes/sheets had dust mites in them.
Not all people are as sensitive to the bites but for those who are, this was a
recipe for disaster ... or at least a lot of short-term intense itching.
How do we solve this
dilemma? When the patient presents to the office with these symptoms, part of
the history I take will be to ask if they recently started wearing the warmer
clothes mentioned above or were using blankets they have been in storage or on
a rack the last six months.
I also find out if they
washed them prior to use. Most of the time, the answer is no, because the
clothes were clean when they stored them there for the winter. A mid-potency
topical steroid and non-sedating anti-histamine can be given to alleviate
symptoms and patients should be encouraged to wash all remaining clothes and
linens prior to use, as well as using any one of the commercially available
sprays that can kill dust mites and bed bugs.