Maynard-Burrows CL, Mclennan JV, Nicholson-Roberts TC, Takano H. Blister beetle dermatitis caused by cantharidin in South Sudan in Op TRENTON: a case series.
J ROY ARMY MED CORPS 2019;
167:362-364. [PMID:
30826753 DOI:
10.1136/jramc-2019-001186]
[Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Revised: 02/12/2019] [Accepted: 02/12/2019] [Indexed: 11/04/2022]
Abstract
Cantharidin-producing blister beetles are found worldwide. The pathognomonic feature of their toxin is a blistering dermatitis that presents an environmental health hazard. Cutaneous exposure to cantharidin can produce blistering dermatitis, most commonly seen on exposed skin, in the Bentiu region of South Sudan. This should be treated with appropriate cleaning, debridement and regular dressing changes to cope with extensive initial exudate. The best dressing combinations found were initial treatment with povidone-iodine and hydrocolloid, followed by hydrocolloid only. Hydrocolloid dressings were found to be the most effective at staying in place with South Sudan's high humidity. Prevention strategies should include covering exposed skin, wearing wide-brimmed hats, neck scarves and enclosed footwear, and avoidance of working under white light. Medical personnel should engage with the chain of command to include appropriate force protection education within the arrivals brief.
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