Video:Breakfast, lunch, and dinner sign

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Breakfast, lunch and dinner sign refers to a pattern of small bumps in the skin seen following insect bites.[1]


Generally, three to five appear close together at the same time, typically in a cluster or line, on exposed parts of the body such as the face, neck, arms, or legs.[2][3] The bites may appear pinkish, sometimes surrounded by swelling.[3]


Unable to fly, insects such as fleas and bed bugs generally jump or walk to bite, causing the bite marks to appear close together.[4][5] An enzyme in the saliva of the insect may cause a local allergic reaction, resulting in a larger bump that is itchy and more reddish.[3]


Diagnosis is by its appearance.[3]


This sign is common.[3] Prevention lies in insect control within the environment and from pets.[3]


Treatment includes applying a steroid cream to reduce redness and swelling, and antihistamines to reduce itch.[3]


  1. Bolognia, Jean L.; Schaffer, Julie V.; Duncan, Karynne O.; Ko, Christine (2021). "55. Disorders of hyperpigmentation". Dermatology Essentials (2nd ed.). Elsevier. p. 522. ISBN 978-0-323-70971-2. Archived from the original on 2023-08-11. Retrieved 2023-08-09.
  2. Madke, B; Nayak, C (September 2012). "Eponymous signs in dermatology". Indian dermatology online journal. 3 (3): 159–65. doi:10.4103/2229-5178.101810. PMID 23189246.
  3. 3.0 3.1 3.2 3.3 3.4 3.5 3.6 Peres, Gabriel; Yugar, Lara Buonalumi Tacito; Haddad Junior, Vidal (October 2018). "Breakfast, lunch, and dinner sign: a hallmark of flea and bedbug bites". Anais Brasileiros de Dermatologia. 93 (5): 759–760. doi:10.1590/abd1806-4841.20187384. PMID 30156636. Archived from the original on 2023-05-15. Retrieved 2023-07-31.
  4. Paller, Amy S.; Mancini, Anthony J. (2020). "18. Infestations, bites, and stings". Paller and Mancini - Hurwitz Clinical Pediatric Dermatology: A Textbook of Skin Disorders of Childhood and Adolescence (6th ed.). St. Louis, Missouri: Elsevier. p. 512. ISBN 978-0-323-54988-2. Archived from the original on 2023-08-11. Retrieved 2023-08-10.
  5. Eichenfield, Lawrence F.; Frieden, Ilona J.; Mathes, Erin; Zaenglein, Andrea (25 August 2014). Neonatal and Infant Dermatology. Elsevier Health Sciences. p. 212. ISBN 978-1-4557-2639-4. Archived from the original on 14 August 2023. Retrieved 12 August 2023.