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Inbamani APD, Sundaram G, Ramalingam R. Morphological and Clinical Patterns of Paederus Dermatitis. Cureus 2024; 16:e58813. [PMID: 38784336 PMCID: PMC11112970 DOI: 10.7759/cureus.58813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/22/2024] [Indexed: 05/25/2024] Open
Abstract
Background The objective of the present study was to describe the morphological and clinical patterns of paederus dermatitis (PD). Methodology This retrospective case series was conducted in the outpatient department of the Department of Dermatology, Srinivasan Medical College and Hospital, Trichy, Tamil Nadu, between June 2023 and August 2023 among patients with a clinical diagnosis of PD. Results This study included a total of 10 patients. The mean (SD) age of the patients was 19.4 (1.9) years. More than half of the patients (60.0%) were males. Of the 10 patients included, four (40.0%) were from rural areas, three (30.0%) were from urban areas, and three (30.0%) were from semi-urban areas. The maximum number of cases was reported between June and September. The most common presenting complaint was a burning sensation in 80.0% of the patients, followed by pain in 80.0% and blisters in 20.0% of the patients. The mean (SD) duration of the lesion was 4.2 (1.3) days. Regarding the clinical pattern of lesions, linear lesions were the most common (40.0%), followed by erythematous lesions with central gray area in 30.0%, kissing lesions in 20.0%, and burnt appearance in 10.0% of the lesions. Nearly half of the patients presented with lesions in the face (40.0%), the most common site in the present study, followed by lesions in the leg (20.0%), and lesions in the axilla, chest, arm, and back (10.0% each). Conclusions Understanding the epidemiology and clinical manifestations of this condition is crucial for accurate diagnosis, timely management, and public health interventions aimed at preventing Paederus beetle-related dermatitis.
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Tamilselvan B, Shanmugam S, Shakthi P. A Case Series of Paederus Dermatitis: Understanding Its Varied and Diverse Clinical Presentations. Cureus 2024; 16:e54148. [PMID: 38496106 PMCID: PMC10942126 DOI: 10.7759/cureus.54148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/13/2024] [Indexed: 03/19/2024] Open
Abstract
Introduction Paederus dermatitis arises from inadvertent skin contact with insects of the genus Paederus, leading to irritant contact dermatitis. This study aims to highlight the diverse clinical presentations and the remarkable ability of the disease to mimic various dermatological conditions. Methodology A total of 15 patients diagnosed with Paederus dermatitis in a period of four months from August 2023 to November 2023 were included in this retrospective study. The demographic profile, detailed history, clinical presentation, and site of lesion distribution were documented. Results Out of 15 patients, nine were males, and eight were females. All patients exhibited a sudden onset of lesions accompanied by burning and pain, with an average duration of approximately 2.5 days. The most prevalent clinical presentation was the linear type, followed by kissing lesions, an erythematous patch with a central gray area, Nairobi eye, burnt appearance, and post-inflammatory pigmentation. Conclusion Paederus dermatitis is common in tropical areas like India but is prone to misdiagnosis due to its varied presentation. Increased awareness can lead to accurate diagnoses and simpler treatment plans, reducing patient confusion.
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Affiliation(s)
| | - Srikanth Shanmugam
- Dermatology, Mahatma Gandhi Medical College and Research Institute, Puducherry, IND
| | - Pragasam Shakthi
- Dermatology, Mahatma Gandhi Medical College and Research Institute, Puducherry, IND
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Palaniappan V, Karthikeyan K. A Clinico-Epidemiological Study of Paederus Dermatitis in a Tertiary Care Center in Puducherry, India. Indian Dermatol Online J 2023; 14:558-560. [PMID: 37521211 PMCID: PMC10373835 DOI: 10.4103/idoj.idoj_451_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 09/26/2022] [Accepted: 10/16/2022] [Indexed: 08/01/2023] Open
Affiliation(s)
- Vijayasankar Palaniappan
- Department of Dermatology, Venereology and Leprosy, Sri Manakula Vinayagar Medical College and Hospital, Puducherry, India
| | - Kaliaperumal Karthikeyan
- Department of Dermatology, Venereology and Leprosy, Sri Manakula Vinayagar Medical College and Hospital, Puducherry, India
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Paederus Dermatitis Outbreak in Addis Ababa, Ethiopia: A Case-Control Study. JOURNAL OF ENVIRONMENTAL AND PUBLIC HEALTH 2021; 2021:8892785. [PMID: 33815513 PMCID: PMC7987415 DOI: 10.1155/2021/8892785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Revised: 03/05/2021] [Accepted: 03/09/2021] [Indexed: 12/02/2022]
Abstract
Background Paederus dermatitis is an irritant contact dermatitis caused by crushing insects of the genus Paederus, which releases a vesicant toxin called pederin. On July 28, 2018, the district health office received a report of cases with erythema, itching, and burning after contact with the Paederus insect. In response, we investigated the outbreak intending to describe, confirm, and identify the risk factors associated with the country's first reported outbreak. Methods A community-based unmatched case-control study was conducted from August 10 to 22, 2018. Two hundred twenty-five (75 cases and 150 controls) study participants were involved in the study. Cases were defined as Bole subcity residents who had acute contact dermatitis after contact with the insect, while controls were persons who did not have contact with the insect. Cases were recruited consecutively as they present, whereas controls were selected by the neighborhood sampling method. An interviewer-administered questionnaire was used for the data collection, and multiple logistic regression was applied to determine the independent risk factors. The results were expressed as adjusted odds ratios (AORs) and 95% confidence intervals (CIs). Results A total of 122 cases were reported from the three districts of the subcity. The mean age of cases and controls was 23.6 (SD ± 16.4) and 29.4 (SD ± 10.9) years, respectively. Multivariate analysis showed that the presence of outdoor light (AOR = 5.1; 95% CI (2.5, 10.9), presence of rotten leaves (AOR = 6.4; 95% CI (2.9, 15.7)), sleeping on the floor (AOR = 6.1; 95% CI (2.5, 15.7)), wearing protective clothing (AOR = 0.2; 95% CI (0.1, 0.4)), and use of insect repellant (AOR = 0.1; 95% CI (0.0, 0.4)) were significantly associated with Paederus dermatitis outbreak. Conclusion The investigation identified exposure to artificial light and the presence of rotten leaves around the residential area as important factors leading to an increase in the odds of Paederus dermatitis. In contrast, the use of insect repellant and wearing protective clothing were shown to provide protection. The investigation determined that reducing burning outdoor lights, cleaning excess vegetation, avoiding sleeping on the floor, using insect repellants, and wearing protective clothing can reduce the risk of contracting Paederus dermatitis.
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Mouinga Abayi DA, Mvé Mengome E. [Periorbital Paederus dermatitis: A case report]. J Fr Ophtalmol 2021; 44:e295-e297. [PMID: 33487452 DOI: 10.1016/j.jfo.2020.06.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Accepted: 06/18/2020] [Indexed: 10/22/2022]
Affiliation(s)
- D A Mouinga Abayi
- Service d'ophtalmologie, hôpital d'instruction des Armées Omar Bongo Ondimba, BP 20404, Libreville, Gabon.
| | - E Mvé Mengome
- Service d'ophtalmologie, hôpital d'instruction des Armées Omar Bongo Ondimba, BP 20404, Libreville, Gabon
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Trannoy P, Villemant C, Roux P, Bounes V, Gallart JC. Dermatite à Paederus : gestion d’un cas par télémédecine par le Centre de Consultation Maritime Médicale (CCMM) de Toulouse et grâce à l’identification entomologique du Muséum National d’Histoire Naturelle. TOXICOLOGIE ANALYTIQUE ET CLINIQUE 2020. [DOI: 10.1016/j.toxac.2019.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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De Luca D, Maianski Z, Averbukh M. Paederus dermatitis outbreak in Luanda City, Angola. J Eur Acad Dermatol Venereol 2017; 32:e17-e18. [DOI: 10.1111/jdv.14435] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- D.A. De Luca
- Luanda Medical Center; Rua Amilcar Cabral No 3 Ingombota Luanda Angola
| | - Z. Maianski
- Luanda Medical Center; Rua Amilcar Cabral No 3 Ingombota Luanda Angola
| | - M. Averbukh
- Luanda Medical Center; Rua Amilcar Cabral No 3 Ingombota Luanda Angola
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Uzunoğlu E, Oguz ID, Kir B, Akdemir C. Clinical and Epidemiological Features of Paederus Dermatitis Among Nut Farm Workers in Turkey. Am J Trop Med Hyg 2016; 96:483-487. [PMID: 27879459 DOI: 10.4269/ajtmh.16-0582] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Accepted: 09/16/2016] [Indexed: 11/07/2022] Open
Abstract
Paederus dermatitis is an acute irritant dermatitis resulting from contact with the hemolymph of Paederus beetles. This dermatitis mimics other infectious skin disorders, often resulting in diagnostic dilemmas. This study of 46 patients was conducted to increase awareness about Paederus dermatitis. Possible causes of a number of cases of Paederus dermatitis in Giresun, Turkey, were investigated using climate data and telephone interviews with the patients about risk factors. Insects caught by patients were identified at the species level. All patients were hazelnut farm workers and admitted to the hospital in the months during which the hazelnut harvesting occurs. Of the patients, 11 (23.91%) presented with painful and burning skin lesions, and 35 (70.09%) complained of itching. The neck was the most involved site (47.83%). The predominant type of lesion was erythematous plaque (84.78%). No pathological findings were detected by laboratory testing. Patients reported coming into contact with the insect during the daytime. Captured insects were identified as Paederus fuscipes. Although the weather and climate were optimal for P. fuscipes during June-October, patients were admitted to the hospital only during the hazelnut harvesting season (August-September). The only risk factor identified among patients was occupation; hence we believe our study is the first to suggest that Paederus dermatitis is an occupational disease among hazelnut farm workers. We suggest that Paederus spp. may become a substantial threat due to global warming, especially among farm workers. Paederus dermatitis is not included in classic medical textbooks. It is necessary to increase awareness about this condition.
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Affiliation(s)
- Emel Uzunoğlu
- Department of Medical Microbiology, Giresun University Medicine Faculty, Giresun, Turkey.
| | - Isıl Deniz Oguz
- Department of Dermatology, Giresun Prof. Dr. A. Ilhan Ozdemir State Hospital, Giresun, Turkey
| | - Busra Kir
- Department of Medical Microbiology, Giresun University Medicine Faculty, Giresun, Turkey
| | - Cihangir Akdemir
- Department of Medical Microbiology, Giresun University Medicine Faculty, Giresun, Turkey
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Kollipara R, Reisz G, Reisz C. Control of the rove beetle in rapidly deployed Ebola treatment units (ETUs) is necessary for worker safety. JAAD Case Rep 2016; 1:406-7. [PMID: 27051794 PMCID: PMC4809395 DOI: 10.1016/j.jdcr.2015.10.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Affiliation(s)
- Ramya Kollipara
- Department of Dermatology, Texas Tech Health Sciences Center, Lubbock, Texas
| | | | - Colleen Reisz
- School of Medicine, University of Missouri-Kansas City, Kansas City, Missouri
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Beaulieu BA, Irish SR. Literature review of the causes, treatment, and prevention of dermatitis linearis. J Travel Med 2016; 23:taw032. [PMID: 27178160 DOI: 10.1093/jtm/taw032] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/18/2016] [Indexed: 11/12/2022]
Abstract
BACKGROUND Dermatitis linearis is a skin condition that affects both local populations and travelers alike. Dermatitis linearis is caused by some beetles within the subtribe Paederina and manifests as painful lesions, blisters and intense itching. Though outbreaks are widespread, the condition as a whole still remains relatively unknown. METHODS An extensive search of the existing Paederus literature was conducting in order to elucidate relevant information regarding the occurrence of outbreaks, seasonality, exposure and symptom onset, and management of dermatitis linearis. Special consideration was given to behavioral and environmental factors. RESULTS Epidemics of dermatitis linearis are most commonly observed during the rainy season or after particularly hot and humid weather patterns. Symptom onset is typically delayed 6-48 h after exposure. The most common symptoms are stinging, burning and itching, with later development of erythematous plaques and blisters. Though symptoms of dermatitis linearis resolve spontaneously, wet compresses, antihistamines and topical steroid ointments and lotions are recommended to alleviate symptoms. CONCLUSIONS Dermatitis linearis in travelers and local populations can be prevented through minimizing or modifying sources of artificial light, using pesticide-treated nets near beds and lights, general housekeeping and vegetation maintenance, and by raising awareness regarding the conditions caused by Paederus.
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Affiliation(s)
- Brooke A Beaulieu
- Georgia State University, School of Public Health, Atlanta, GA 30302 USA
| | - Seth R Irish
- Research Entomologist, Entomology Branch, Department of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Atlanta GA, 30329, USA
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[Vesicular contact dermatitis due to Paederus in Cameroon and review of the literature]. ACTA ACUST UNITED AC 2015; 108:328-36. [PMID: 26608274 DOI: 10.1007/s13149-015-0459-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2015] [Accepted: 10/06/2015] [Indexed: 10/22/2022]
Abstract
This irritant blister dermatitis is caused by the genus Paederus whose geographical distribution is worldwide, with a higher incidence in tropical areas. It is induced by direct skin contact with pederin, a blistering and caustic substance found in the abdomen (coelome) of Paederus insects (insect order Coleoptera: family Staphylinidae). The diagnosis is based on the presence of typical clinical features combined with compatible epidemiological features. Our goal is to describe the epidemiological and clinical features of this irritant contact dermatitis in Cameroon through a retrospective study conducted at the end of the rainy season at the Oku Hospital in Northwest Cameroon and to also include cases reported at the medical center of the French Embassy in Yaounde during this same timeframe. In addition, we conducted a literature review of paederus dermatitis. Nineteen patients were included in this study. More than half of the patients presented with more than two lesions predominantly localized to the face or the neck; less than half had complications manifesting as either localized or respiratory reactions and three patients presented periorbital involvement. This study confirms the presence of paederus dermatitis in Cameroon. It is mainly localized in the unusual geoclimatic region of the western high mountains within the country, as well as the usual warm, moist areas of Yaounde. The clinical evolution of this dermatitis is usually one of spontaneous and uneventful resolution with complications being rare. Curative treatment is one of localized topical therapies while oral antibiotic therapy should be reserved for more complicated cases.
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Bong LJ, Neoh KB, Jaal Z, Lee CY. Paederus Outbreaks in Human Settings: A Review of Current Knowledge. JOURNAL OF MEDICAL ENTOMOLOGY 2015; 52:517-526. [PMID: 26335457 DOI: 10.1093/jme/tjv041] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/15/2014] [Accepted: 03/18/2015] [Indexed: 06/05/2023]
Abstract
Although rove beetles (Paederus spp.) play a beneficial role as biological control agents to manage crop pests in agro-ecosystems, their high prevalence in human settings has elevated them to pest status in urban areas. Rove beetles neither bite nor sting, but accidental crushing on human skin causes them to release the toxin paederin, which causes dermatitis linearis. This review integrates currently available knowledge about the issues pertaining to Paederus infestation. For instance, the results of life history studies conducted under different food and temperature regimes are summarized, as they indicate how large a population can be in a habitat to cause massive and widespread infestation and illustrate the physiological traits required to maintain the population at the maximum level even under adverse conditions. In contrast to what is generally reported, we speculate that climatic factors do not necessarily result in Paederus dispersal in temperate regions; instead, habitat disturbance and site unsuitability may be the main factors that lead to massive dispersal to human settings. Factors such as whether dispersers are adaptable to xeric conditions in human settings, the probability that dispersed Paederus mate with the opposite sex, and whether dispersers have adequate nutrient intake to reproduce are considered to evaluate their potential to reproduce in human settings. Finally, the effectiveness of current commercial insecticides, challenges faced in managing infestations, and sustainable management practices are discussed to provide information for long-term control programs.
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Affiliation(s)
- Lee-Jin Bong
- Laboratory of Innovative Humano-habitability, Research Institute for Sustainable Humanosphere, Kyoto University, Gokasho, Uji, Kyoto 611-0011, Japan. Vector Control Research Unit, School of Biological Sciences, Universiti Sains Malaysia, 11800 Penang, Malaysia.
| | - Kok-Boon Neoh
- Laboratory of Innovative Humano-habitability, Research Institute for Sustainable Humanosphere, Kyoto University, Gokasho, Uji, Kyoto 611-0011, Japan
| | - Zairi Jaal
- Vector Control Research Unit, School of Biological Sciences, Universiti Sains Malaysia, 11800 Penang, Malaysia
| | - Chow-Yang Lee
- Vector Control Research Unit, School of Biological Sciences, Universiti Sains Malaysia, 11800 Penang, Malaysia
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Lima DCB, Costa AAV, Silva FS. Abundance and Night Hourly Dispersal of the Vesicating Beetles of the Genus Paederus (Coleoptera: Staphylinidae) Attracted to Fluorescent, Incandescent, and Black Light Sources in the Brazilian Savanna. JOURNAL OF MEDICAL ENTOMOLOGY 2015; 52:50-55. [PMID: 26336279 DOI: 10.1093/jme/tju006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Paederus beetles are cosmopolitan medically important insects that cause dermatitis linearis to humans. In Brazil, despite the medical importance of these beetles, no studies focusing directly on the abundance and ecological features of harmful species exist. Therefore, this study aims at determining the abundance and the nocturnal hourly dispersal of Paederus species attracted to fluorescent, incandescent, and black light sources in the Brazilian savanna. Paederus species were captured from May to September for three consecutive years, between 2011 and 2013. The specimens were caught hourly, from 1800 to 0600 hours. Paederus beetles were attracted to incandescent, fluorescent, and black light lamps as light sources. A total of 959 individuals of five species were collected. The collected species were Paederus protensus Sharp (59.85%), Paederus columbinus Laporte de Castelnau (29.20%), Paederus mutans Sharp (7.09%), Paederus brasiliensis Erichson (3.34%), and Paederus ferus Erichson (0.52%). The black light was the most attractive source, and the darkest collecting point was the most representative for the number of individuals. The lowest catches were captured at full moon, and the highest catches were between 2200 and 0100 hours. Future investigations are needed to better understand the role of night temperature and soil humidity affecting the seasonal growth of Paederus beetle populations of northeastern Brazil.
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Affiliation(s)
- D C B Lima
- Laboratory of Medical Entomology, Center for Agrarian and Environmental Sciences, Federal University of Maranhão, Chapadinha, Maranhão 65500-000, Brazil
| | - A A V Costa
- Laboratory of Medical Entomology, Center for Agrarian and Environmental Sciences, Federal University of Maranhão, Chapadinha, Maranhão 65500-000, Brazil
| | - F S Silva
- Laboratory of Medical Entomology, Center for Agrarian and Environmental Sciences, Federal University of Maranhão, Chapadinha, Maranhão 65500-000, Brazil.
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Turan E. Paederusdermatitis in Southeastern Anatolia, Turkey: a report of 57 cases. Cutan Ocul Toxicol 2013; 33:228-32. [DOI: 10.3109/15569527.2013.834499] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Drouet G, Glaizal M, Schmitt C, Kervégant M, Tichadou L, de Haro L. Pédérose ou dermatite à Paederus : quatre observations en Provence. Presse Med 2013; 42:355-7. [DOI: 10.1016/j.lpm.2012.04.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2012] [Revised: 03/26/2012] [Accepted: 04/10/2012] [Indexed: 11/15/2022] Open
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Cressey BD, Paniz-Mondolfi AE, Rodríguez-Morales AJ, Ayala JM, De Ascenção Da Silva AA. Dermatitis linearis: vesicating dermatosis caused by paederus species (coleoptera: staphylinidae). Case series and review. Wilderness Environ Med 2013; 24:124-31. [PMID: 23352312 DOI: 10.1016/j.wem.2012.11.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2012] [Revised: 10/01/2012] [Accepted: 11/01/2012] [Indexed: 10/27/2022]
Abstract
OBJECTIVE Outbreaks of dermatitis linearis have been documented worldwide. We present a case series of dermatitis linearis from Latin America to highlight the importance of this clinical entity. Clinical, historical, epidemiological, and pathological aspects of the condition are discussed, and a concise current approach to the management and treatment of this morbidity is presented. METHODS We present a series of 4 selected cases reflecting the clinical spectrum exhibited in dermatitis linearis by Paederus along with a review of the literature. RESULTS In this review we demonstrate the need for awareness of dermatitis linearis as a clinical entity that must be considered in the broad list of differential diagnosis embracing vesicating linear lesions. CONCLUSIONS Capture of the insect, epidemiologic features, and a high clinical suspicion can aid in making the correct diagnosis. Primary prevention through public awareness, decreased use of artificial lighting, and mosquito nets can limit the extent and severity of outbreaks.
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Nairobi fly (Paederus) dermatitis in South Sudan: a case report. Wilderness Environ Med 2012; 23:251-4. [PMID: 22683362 DOI: 10.1016/j.wem.2012.03.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2011] [Revised: 02/21/2012] [Accepted: 03/11/2012] [Indexed: 11/22/2022]
Abstract
A 28-year-old nursing student working in Juba, South Sudan, suddenly developed a rash over her mid-right clavicle. Beginning as a 10-cm-diameter erythematous patch with an irregular border, within 24 hours it had developed an increasingly gray, necrotic center, appearing similar to a burn. The patient was seen by 2 local physicians without a diagnosis being made. Ultimately, it was diagnosed as being caused by the toxic hemolymph, pederin, from the Nairobi fly (Paederus). The rash usually affects body parts not covered by clothing; healing time ranges from 7 to 28 days, usually with permanent skin discoloration. Preventive measures include typical antivector precautions, including bed nets, long-sleeve clothing, and avoiding fluorescent lights. If the beetles are found on the skin, brushing them off, rather than crushing them, avoids producing dermatitis. Treatment includes rapidly washing the affected area, applying cold, wet compresses, and possibly treating with antibiotics, steroids, and antihistamines.
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