People’s Pharmacy: Skeeter syndrome can be long-lasting

Q. I suffer from unusually severe reactions to mosquito bites. Each bite causes a red swollen area the size of a quarter. I’ve learned to never scratch, as the red area will grow to several inches and take weeks to clear up.

Last summer, about 20 bites gotten while I was gardening caused an immune system reaction, triggering eczema that lasted for months. After I’d suffered for years, a dermatologist prescribed triamcinolone. It’s been life-changing. Just the smallest dab on a mosquito bite makes it disappear within 24 hours. A bite rarely needs a second application. Why isn’t this medicine mentioned as a treatment for extreme mosquito bite reactions?

A. There is a medical term for your exaggerated reaction to mosquito bites. It’s called “skeeter syndrome” (American Family Physician, Dec. 15, 2013). The intense redness and itching are caused by allergens in the saliva of mosquitoes. Symptoms can persist far longer than a typical bite response. Why some people are hypersensitive remains a mystery.

The best way to overcome such reactions is with topical prescription-strength corticosteroids, like triamcinolone. The sooner they are applied after a bite, the better. Oral prednisone is sometimes warranted in the case of an extreme bite reaction.

Q. I used the brand Imitrex for migraine headaches for years with excellent results. After being switched to generic sumatriptan, I get only half the headache relief that Imitrex provided. Often the headaches recur, dragging on for days. What’s more, I get hives every time I take the medication. I never had hives with Imitrex. I can’t afford over $700 for the brand-name medicine. What can you suggest?

A. The Food and Drug Administration has assured the public that all generic drugs are the same as their brand-name counterparts. Despite this, many people report changes in effectiveness or unexpected side effects when they take the generic versions. Your hives could be a reaction to one of the so-called inactive ingredients in generic sumatriptan. The FDA does not require that these be the same as those in the brand-name formulation.

You might consider purchasing brand-name Imitrex from a legitimate Canadian drugstore. The price is dramatically lower than in the U.S. Be careful about selecting the store online, however. It must be registered with a Canadian province in which it has brick-and-mortar stores. You will find criteria and a list of reputable pharmacies in our Guide to Saving Money on Medicines. This is available at www.PeoplesPharmacy.com.

Q. I have never understood why exposure to the sun is supposed to be the major cause of skin cancers. My husband never went out without a shirt (or more covering) on his body and never sunbathed. He probably didn’t spend more than two weeks total in his life at any beach or pool. In short, his shoulders and upper chest were never exposed to much sunlight.

So why did he get a melanoma under his left clavicle? I just don’t get it.

A. Your husband’s experience is not unique. Other people have developed melanomas in sites that were not drenched in sun. However, researchers have affirmed that a substantial proportion of melanomas can be attributed to ultraviolet exposure (Journal of the European Academy of Dermatology and Venereology, October 2018).

It is always a good idea to avoid sunburn and excessive sun exposure. Covering up, as your husband did, is recommended. Obviously, it wasn’t enough to prevent his melanoma. Staying out of the sun at midday is also wise.