<unk>  bites<unk>  bites Skin The most common skin findings associated with<unk> s are pruritic, maculopapular, erythematous lesions. Each lesion is about 2–5 mm but may be as large as 2 cm in diameter and there may or may not be the presence of a central punctum. Bites are usually present on areas of exposed skin, especially exposed areas not covered by sheets or blankets, such as arms, legs, feet, face or neck. Individual responses to bites vary, ranging from no visible effect (in about 20–70%), to small flat (macular) spots, to the formation of prominent blisters (wheals and bullae) along with intense itching that may last several days. Vesicles and nodules may also form. The lesions due to bites may become secondarily infected due to scratching but systemic effects from<unk>  bites are very rare. A central spot of bleeding may also occur due to the release of blood thinning substances in the<unk> 's saliva. Symptoms may not appear until some days after the bites have occurred. Reactions often become brisker after multiple bites due to possible sensitization to the salivary proteins of the<unk> . Numerous bites may lead to a red rash or hives. Psychological Serious infestations and chronic attacks can cause anxiety, stress, and sleep difficulties. Development of refractory delusional parasitosis is possible, as a person develops an overwhelming obsession with<unk> s. Other A number of other symptoms may occur from either the bite of the<unk> s or from their exposure. Serious allergic reactions including anaphylaxis from the injection of serum and other nonspecific proteins have been rarely documented. Due to each bite taking a tiny amount of blood, chronic or severe infestation may lead to anemia. Bacterial skin infection may occur due to skin break down from scratching. Systemic poisoning may occur if the bites are numerous. Exposure to<unk> s may trigger an asthma attack via the effects of airborne allergens although evidence of this association is limited. There is no evidence that<unk> s transmit infectious diseases even though they appear physically capable of carrying pathogens and this possibility has been investigated. The bite itself may be painful thus resulting in poor sleep and worse work performance. Similar to humans,<unk> s can feed on other warm-blooded animals such as pets. The signs left by the bites are the same as in the case of people and cause identical symptoms (skin irritation, scratching etc).<unk> s can infest poultry sheds and cause anemia and a decrease in egg production in hens.
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