Toxisch-irritative Dermatitis durch Prozessionsspinnerraupen nach Portugalaufenthalt

Abstract

Caterpillars of the pine and the oak processionary moth, endemic in many European countries, produce poisonous hairs (setae) from its third to fifth larval stage. These setae contain highly allergenic, urticating proteinsdefined as thaumetopoein which induces various symptoms of lepidopterism, most frequently associated with pruritus and dermatitis. T. pityocampa directly induce dermatitis by a toxic-irritative, non-IgE-mediated mechanism. Additionally, true allergenic reactions to Tha p 1, a highly immunogenic 15 kDa protein fraction has been demonstrated most recently by positive skin prick tests and specific IgE determination by immunoblotting. Preliminary investigations showed that cross-reacting thaumetopoein-like fractions occur in T. processionata. Herein, we report on a 40-year-old German female suffering from toxic-irritative dermatitis approximately two weeks after returning home from vacation to Portugal. The initially suspected communicable form of urticaria could be linked to a contact dermatitis produced by setae of the pine processionary caterpillar imported from Portugal by clothing and personal utensils. This is the first documented case of a severe form of processionary caterpillar dermatitis introduced from southern European recreational areas to Germany. Secondary infections have to be prevented therapeutically. Decontamination of setae from the personal environment as well as from personal utensils resulted in the effective prevention of new skin lesions. The documented case reveals that dermatitis caused by processionary caterpillars is obviously still widely unknown although sylvatic mass infestation by the oak processionary caterpillar does frequently occur in central Europe potentially causing outbreaks of lepidopterism.