Papular urticaria is a chronic or recurrent pruritic eruption believed to be an allergic (hypersensitivity) reaction to insect bites. It is very common in children, especially in the spring and summer in temperate climates and year round where the weather is warm. It can occur anywhere on the body but tends to occur on the exposed extensor surfaces of the extremities. A history of exposure to fleas, mosquitoes, chiggers, mites, bedbugs, or other small insects should be searched for.

The lesions are firm, pink, raised, 2- to 8-mm papules, often with a visible central punctum. They may become excoriated or secondarily infected. They can last weeks to months and often recur at the same time each year. Often, only one person in the household is affected and caregivers are disbelieving of proposed cause. After resolution of the papule, pigmented (postinflammatory) macules may persist.