Brief Answer:
?Papular urticaria if itching but not painful

Detailed Answer:
Hi XXXXXX,
Thanks for writing in.

There are many types of bugs around and bug bites range from the most mildest form to the severest. The key characteristics of cellulitis are redness, warmth, tenderness, and swelling of the skin. It looks like you have a bugbite of a mild degree as you say there is pruritis but no pain as such. Pruritis or intense itching might arise as a skin hypersensitivity reaction to the bugbite and subsequent skin irritation.

I hope you have taken the basic first aid recommended for bugbites:
1. Remove any stinger. Wash the area with soap and water.
2. Apply a cold pack or cloth filled with ice to reduce pain and swelling.
3. Try a pain reliever, such as ibuprofen or acetaminophen reduce pain
4. Apply a topical cream to ease pain and provide itch relief. Creams containing ingredients such as hydrocortisone or lidocaine may help control pain. 5. Other creams, such as calamine lotion or those containing colloidal oatmeal or baking soda, can help soothe itchy skin.
6. Take an antihistamine containing diphenhydramine (Benadryl, others) or cetrizine.

If there is no pain, tenderness and warmth (I can see the redness), then the possibility of papular urticaria may be considered. Papular urticaria is a dermal hypersensitivity reaction to an insect bite, most commonly from a flea or mosquito and this usually is seen in children and those with a hypersensitive immune system.

The lesions usually develop within hours of a bite and persist for an average of 1 to 2 weeks. The areas typically affected are the head and neck or the upper or lower extremities.Patients most often complain of intense
itching. The pathogenesis is proposed to be mediated by the immune complex, and tissue biopsy study shows increased eosinophils. The eosinophils stimulate mast cells, causing release of histamine, leading to increased vascular
permeability, edema, and erythema.

Please note that my observations are based on the information provided by you and if you are in doubt please discuss in details with your doctor as cellulitis is a medical emergency.

Wishing you good health.

Hope your query is answered.
Do write back if you have any doubts.

Regards,
Dr.Vivek

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