Zig-zag lines of lesions with hemorrhagic puncta and intense itching are characteristic of which bite?

• A. Flea bites
• B. Lice bites
• C. Chigger bites
• D. Scabies

Answer: (A)

Pattern recognition of arthropod bites: a zig-zag line of lesions with small hemorrhagic spots and severe itching points to fleas. Flea bites commonly occur in successive bites as the animal or person moves, producing a linear or clustered, often zig-zag arrangement on exposed skin such as ankles and legs. The tiny puncta can bleed a bit from the flea’s saliva, giving the hemorrhagic puncta appearance.

In contrast, lice bites tend to cluster where hair is nearest the skin and often along the waist or scalp, not typically in a zig-zag line. Chigger bites produce intensely itchy wheals with a central punctum, usually on legs or ankles but without the characteristic zig-zag hemorrhagic pattern. Scabies causes widespread itching with characteristic burrows and interdigital or flexural lesions, rather than a zig-zag line of punctate bites.