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The first documented case of papular urticaria was caused by the larvae.
Papular urticaria may accompany, or even be the first symptom of various viral infections including hepatitis, infectious mononucleosis, or German measles (rubella).
The differential diagnoses are: acrodermatitis enteropathica, erythema infectiosum, erythema multiforme, hand-foot-and-mouth disease, Henoch-Schönlein purpura, Kawasaki disease, lichen planus, papular urticaria, papular purpuric gloves and socks syndrome, and scabies.