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To the Editor.—
I was interested in the recent letter of Daniel S. J. Choy (229:519, 1974) on the failure of a patient with scleroderma to respond to insect bites.Some time ago, when we were doing experiments on insect-bite reaction, I fed Aedes aegypti on the severe, hard, trophic end of the finger of a patient with acroscleroderma. Under the binocular microscope, I observed the feeding process through skin that was hard for penetration even by a 27-gauge hypodermic needle. The mosquito was observed to obtain a complete blood meal, without any awareness of the stick of the mosquito, or without local reaction, on the part of the patient. This shows, as we have observed with other feeding experiments, including the flea, that it is possible for a nonarthropod reactor to get bitten and not be aware of the bite or stick and not have an evident reaction.
Goldman L. Insect Bite of the Skin in Scleroderma. JAMA. 1974;229(14):1866. doi:10.1001/jama.1974.03230520014016
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