Background: Mosquito bite hypersensitivity results from abnormal immune responses to salivary proteins with potent immunomodulatory properties. In children, both type I (immunoglobulin E IgE mediated) and type IV (cell mediated) mechanisms contribute to the reaction spectrum, ranging from localized erythema to extensive inflammatory lesions. Although mosquito-specific IgE assays are commercially available, their diagnostic utility and correlation with clinical severity remain unclear. Objective: The objective was to describe the clinical and immunologic characteristics of children with mosquito hypersensitivity, evaluate the diagnostic relevance of mosquito-specific IgE, and explore associations with atopic background. Methods: A retrospective study was conducted on 206 children who underwent mosquito-specific IgE testing between June 2023 and June 2025. The mosquito allergy group included children with large local reactions, prolonged lesions, or systemic symptoms; the controls had typical reactions only. Clinical features, atopic comorbidities, total IgE levels, eosinophil percentages, and inhalant sensitizations were compared between the groups. Results: Atopic diseases were significantly more common in the mosquito allergy group versus the controls (87.0% versus 52.7%; p Conclusion: In pediatric mosquito hypersensitivity, clinical assessment outweighs mosquito-specific IgE testing for diagnosis. Despite the strong association with atopy, specific IgE positivity remains low, which supports the primacy of clinical history and lesion morphology in diagnostic decision-making.
Dolu et al. (Sun,) studied this question.