Paederus Dermatitis: A severe reaction to Charlie’s kiss

Aparna Barman,Farah Rashid,Mohammad Khursheed Alam,Nafij Bin Jamayet,Sanjida Haque,Taseef Hasan Farook

doi:10.3329/bjms.v20i2.51566

Abstract

Paederus dermatitis is a very painful vesicular condition which is caused by the extremely potent toxin “Pederin” released from an insect calledPaederusfuscipes but commonly known as Charlie.A 26 years old woman presented with a sudden onset of neuralgia, arthralgia of left jaw, fever, nausea and fatigue with generalized pain radiating to the neck and lower jaw as well as itch-like sensation on their left arm associated with acute inflammation which began 24-48 hours prior. The patient refused to go to the hospital due to the current pandemic situation but instead updated us daily on her conditions with photographic changes of the arm until complete resolution of symptoms. This case report accounts for the daily sequential changes experienced by a patient after severe reaction to an exposure of pederin with photographs of the affected site. While the painful lesion and all systemic conditions resolved spontaneously over time, a scar was left to mark the unpleasant period. Bangladesh Journal of Medical Science Vol.20(2) 2021 p.459-462

Highlights

Paederus dermatitis; a painful vesicular lesion is caused by the most powerful toxin, ‘Pederin’ within the animal kingdom[1,2]
A26-year-old female dental studentrecently diagnosed to be free of all infectious and transmissible diseases complained of burning neuralgia and arthralgia of left arm and neck region
Pederin is produced by gram-negative pseudomonas bacteria 1which trigger apoptotic effects on the layers of the dermis, thereby disrupting DNA and protein synthesis[1,5,8]

Summary

Introduction

Paederus dermatitis; a painful vesicular lesion is caused by the most powerful toxin, ‘Pederin’ within the animal kingdom[1,2]. The toxin is said to be 15 times stronger than cobra venom and yet is released from an insect (Paederusfuscipes, locally known as Charlie) roughly 7-10 mm in size(Figure 1) 3,4. A26-year-old female dental studentrecently diagnosed to be free of all infectious and transmissible diseases complained of burning neuralgia and arthralgia of left arm and neck region. It began 24-48 hours prior with 100F fever, nausea, fatigue, and an itching sensation on the left forearm. Paederus Dermatitis: A severe reaction to Charlie’s kiss Figure 1: The Paederusfuscipes (Charlie beetle)

Discussion

Conclusion