Investigation and clinical treatment of 52 cases of Paederus dermatitis in the peacekeeping mission area of the Democratic Republic of the Congo

Abstract

Objective To investigate the clinical feature, behavioral factors and treatment method of patients with Paederus dermatitis in the peacekeeping mission area of the Democratic Republic of the Congo (DRC), and we provide an effective protocol for scientific prevention and control of Paederus dermatitis. Methods A epidemiological investigation was performed on general data, behavioral factors and clinical feature of 52 patients who were diagnosed with Paederus dermatitis between May 2018 and April 2020 in the Level Ⅱ Hospital of China. Meanwhile the clinical efficacy of drugs was also analyzed. Results In the peacekeeping mission area of the DRC, Paederus dermatitis is a seasonal disease, and the number of cases has gradually increased since October every year. The peak incidence of Paederus dermatitis appears from January to March of the following year. Patients were mainly located in the suburbs (50 cases, 96.15%) and most of them were outdoor workers (48 cases, 92.3%). Among them, 21 cases (40.4%) had a clear history of contact with Paederus during the day, 20 cases (38.5%) slept with window opening, 16 cases (30.8%) slept using fluorescent lights in their houses, 18 cases (34.6%) slept without screen window , and 15 cases (28.9%) slept with leaving limbs exposed. None of the patients used mosquito nets, repellents and protective clothing. The neck and forearm were the most involved site. The most cutaneous manifestation was erythematous patch (80.77%), occasionally with characteristic vesicular linear or “kissing” lesions. Most patients felt burning pain (88.46%), and few patients felt pruritus (11.54%). The treatments of oral antihistamines, calamine lotion, steroid and antibiotics were effective. For patients with ocular involvement, treatments of oral prednisone and Bufexamac Cream were effective. Conclusion It will be helpful for early diagnosing and selecting appropriate treatment of Paederus dermatitis, by mastering the epidemiology and clinical features of Paederus dermatitis, as well as improving cognitive level of the doctors in the Level II hospitals on the Paederus dermatitis. 摘要：目的 调查研究刚果（金）维和任务区隐翅虫皮炎患者的发病特点、行为因素及临床治疗情况，为科学防控 隐翅虫皮炎提供有效依据。 方法 选择 2018 年 5 月—2020 年 4 月在刚果（金）维和任务区中国二级医院临床诊断的 52 例隐翅虫皮炎患者为研究对象，对患者的一般资料、行为因素及临床特征进行流行病学调查，并分析药物的临床疗效。 结果 刚果（金）任务区的隐翅虫皮炎具有明显的季节性，每年自 10 月起发病数逐渐增多，次年 1—3 月为高峰期。患 者驻地主要分布在郊区，有 50 例（96.15%），多见于户外工作者，为 48 例（92.3%）, 其中白天有明确隐翅虫接触史者 21 例 （40.4%），夜间开窗就寝者 20 例（38.5%），夜间开荧光灯就寝者 16 例（30.8%），未使用纱窗者 18 例（34.6%），就寝时四肢 裸露者 15 例（28.9%），所有患者未使用蚊帐、驱蚊剂及防护服。颈部、前臂为最容易发生的部位；皮损主要呈斑片状红 斑分布（80.77%），并可见特征性条索状或“吻唇样”改变。患者自觉烧灼痛（88.46%），少数为瘙痒感（11.54%）。常规予 以 5% 碳酸氢钠溶液擦洗，口服抗组胺药、外用炉甘石洗剂、抗生素联合糖皮质激素软膏是有效治疗手段。对于眶周受 累患者，口服强的松，用丁苯羟酸乳膏，获得良好效果。 结论 掌握隐翅虫皮炎的流行病学特点，增强二级医院医护人 员对隐翅虫皮炎的认识水平，准确识别临床特征，有助于早期诊断并选择合适的治疗方案。