Beetle Dermatitis Research Articles

Dermoscopic Differentiation of Blister Beetle Dermatitis and Herpes Zoster: an Observational Study.

Blister beetle dermatitis (BBD) and herpes zoster (HZ) manifest suddenly with vesicular lesions mimicking each other and progress rapidly. But a lack of definite differentiating criteria yearns the need for better investigating modality. Though histopathology persuades the need, is an invasive procedure, commonly deferred. Thus, dermoscopy, a non-invasive rapid diagnostic tool, can help in differentiating. To evaluate different dermoscopic patterns of BBD and HZ to differentiate both and to study dermoscopic features in early and late stages of lesions. An observational cross-section study conducted in southern India. Nine patients with clinical features suggestive of BBD and HZ were recruited. Lesions were divided arbitrarily into early and late. Dermoscopic examination was performed with handheld dermoscope. Diagnosis was confirmed by skin biopsy and Tzanck smear wherever necessary. Statistical analysis performed using data in terms of frequencies and percentages. Dermoscopy of early BBD lesions showed multiple discrete and confluent yellowish-white structures, brown dots, roundish white globules, gray structures, 'targetoid pattern', brown areas over intense reddish pink background. Late BBD lesions revealed pinkish-white area, reduced gray structures and, dotted and globular vessels. Early HZ lesions showed poly-lobular gray and brown globules, bright pink background, gray globules covered by grayish veil-like structure with gray rim. Late HZ lesions revealed 'solar eclipse' pattern and 'crumpled fabric' patterns. The dermoscopic findings correlated with histopathology. Dermoscopic patterns show peculiar features consistently pertaining to BBD and HZ, thus help in early diagnosis assisting in accurate treatment in both conditions.

Blister Beetle Dermatitis Outbreaks in Mali.

Meloidae are distributed in temperate and arid regions but are also common in subtropical and tropical savannahs. These insects contain cantharidin, a vesicant substance that can cause poisoning by ingestion and dermatitis by direct contact. We describe recurrent Meloidae-related dermatitis outbreaks and their health impact by analyzing medical consultation records and meteorological data. Between 2015 and 2019, dermatitis outbreaks took place at a French military base at the end of the rainy season, from July to August, with 100 cases reported in 2015, 74 in 2017, 100 in 2018, and 36 in 2019. In 2017, the incidence rate was 4.4% for the base's population. Initial medical consultations represented 31.5% of total medical care activity. Meloidae were identified as Cyaneolytta fryi. These outbreaks of burn-like lesions, although clinically benign, can place a considerable burden on the medical activity of health care facilities. The diagnosis of Meloidae dermatitis is exclusively anamnestic and clinical and requires reported contact with the insect. The treatment protocol is that of standard burn care, and the best preventive measure is to avoid bright white lights. Military personnel, foreign workers, and travelers venturing into the Sahel should be warned of the risks associated with these beetles.

Blister beetle dermatitis with mirror lesions in a cluster of travellers from Kenya

After returning from Kenya, a 20-year old caucasian girl presented with multiple itching and burning erythematous skin lesions in her limbs, which progressively evolved to pustulous linear lesions, some of them with mirror distribution. Toxic dermatitis linearis due to Paederus spp. was confirmed by the identification of rove beetles.

Blistering Beetle Dermatitis Mimicking Herpes Zoster Ophthalmicus: a Case Report

Abstract Blistering beetle dermatitis is an important dermatological disease of tropical countries. Although the clinical features are classical, little awareness amongst medical practitioners may cause difficulties in the diagnosis of this condition. Further, it may sometimes mimic an unrelated disease which can lead to delay in treatment causing prolonged suffering of the patient. We present a case of blistering beetle dermatitis that was initially misdiagnosed as a case of herpeszoster ophthalmicus. The case is presented to reinforce awareness on this dermatologicaldis-ease and discuss its atypical presentation and its management.

Carpet beetle dermatitis mimicking bullous impetigo

A 13-year-old female patient presented with a 3-month history of recurrent blisters, which ruptured into multiple superficial erosions with overlying crust located on the face, neck, and shoulder. Treatment for presumed bullous impetigo showed no benefit. Samples collected from the patient's home revealed the presence of numerous carpet beetles in a wool rug. Carpet beetle dermatitis resembles papular urticaria but may occasionally present as skin lesions resembling bullous impetigo.

An outbreak of blister beetle dermatitis in travellers.

We report an outbreak of Paederus dermatitis in tourists from Zanzibar. This is characterized by linear and round skin lesions with burning and itching sensation, caused by the toxin pederin released by beetles. Contact with beetle very often goes unnoticed. Rarely observed in travellers, Paederus dermatitis is easily misdiagnosed.

Vesicant Dermatitis due to PaederusSp.: Short Communication

We present a very illustrative case of dermatitis caused by Paederus sp affecting a 3 year old healthy boy in the countryside of Brazil. The appearing of painful bullous lesions with clear content in a linear arrangement occurred suddenly, and was later diagnosed to be caused by the beetle popularly known in Brazil as “Potó” which predominate in rural areas. Treatment was realized only with local hygiene with antiseptics and dressing in the eroded areas, in addition to oral acetaminophen. The patient evolved with complete cure of the lesions. We also present a brief review of vesicant dermatitis by Paederus sp. Keywords: Blister Beetle Dermatitis; Paederus Dermatitis; Irritant Contact Dermatitis.

A study of blister beetle dermatitis

<p class="abstract"><strong>Background:</strong> Blister beetle dermatitis is an irritant dermatitis caused mainly by beetles of the genus <em>Paederus</em>. It is clinically characterised by acute onset of linear erythematous plaques mainly over exposed areas like face, neck and upper limb.</p><p class="abstract"><strong>Methods:</strong> Fifty four patients with blister beetle dermatitis who presented to the dermatology outpatient department over a period of three months from May 2017 to July 2017 were included in this study. The various clinical patterns of blister beetle dermatitis observed in these patients are described.<strong></strong></p><p class="abstract"><strong>Results:</strong> Face was the commonest site involved (48%) followed by upper limb (33%). Linear erythematous plaques with or without vesiculation were seen in 78% and kissing lesions were seen in 6 patients. Majority of patients (83%) had burning sensation at the site of the lesions and residual pigmentation was seen in 92% of patients.</p><p><strong>Conclusions:</strong> Blister beetle dermatitis is a common problem in tropical countries like India. Knowledge about the various clinical presentations will help in early diagnosis and treatment. </p>

Blister Mystery

A patient in Sri Lanka presented with a blistering rash in September (Figure 1). What is the diagnosis and how would you treat it? Dermatitis due to blister beetle. Blister beetles (Mylabris pustulata) (Figure 2) are common in South Asia. They are considered pests. Blister beetles are often seen in the vicinity of farmlands during August and September.1Iyer B.H. Guha P.C. Cantharidin from Mylabris pustulata, India.J Indian Inst Sci. 2013; 14: 31Google Scholar They are very sluggish during early morning, becoming more active after sunrise. Blister beetles secrete a yellow-colored oily substance from the leg joints.1Iyer B.H. Guha P.C. Cantharidin from Mylabris pustulata, India.J Indian Inst Sci. 2013; 14: 31Google Scholar, 2Ghoneim K.S. Enhancement of research interests in physiology and biochemistry of blister beetles (Coleoptera: Meloidae): a review.Int Res J Biochem Bioinforma. 2013; 3: 75-92Google Scholar, 3Nyazema N. Cantharidin poisoning: a review.South African Fam Pract. 1989; 10: 70-73Google Scholar This substance contains canthadrine, a skin irritant with high blistering capacity. Blister beetles do not sting or bite, but they release the blistering agent if they are pressed, brushed, or crushed.4James W.D. Berger T.G. Elston D.M. Andrew’s Diseases of the Skin: Clinical Dermatology.11th ed. Saunders Elsevier, Philadelphia2011Google Scholar Skin contact causes a burning, itching, or tingling sensation followed by the appearance of linear or irregular areas of erythema that later form vesicles (Figure 1).4James W.D. Berger T.G. Elston D.M. Andrew’s Diseases of the Skin: Clinical Dermatology.11th ed. Saunders Elsevier, Philadelphia2011Google Scholar, 5Padhi T. Mohanty P. Jena S. Sirka C. Mishra S. Clinicoepidemiological profile of 590 cases of beetle dermatitis in western Orissa.Indian J Dermatol Venereol Leprol. 2007; 73: 333Crossref PubMed Scopus (10) Google Scholar, 6Ajao A.M. Olalubi O.A. Aderolu I.S. et al.Investigation of blister beetle (Lytta vesicatoria) dermatitis outbreak and xontainment at Kwara State University students’ hostels.Sch J Appl Med Sci. 2016; 4: 460-468Google Scholar The vesicles rupture in a few days and form crusts. Secondary infection may occur. Lesions usually heal in a few days when treated with topical antibiotics.4James W.D. Berger T.G. Elston D.M. Andrew’s Diseases of the Skin: Clinical Dermatology.11th ed. Saunders Elsevier, Philadelphia2011Google Scholar, 5Padhi T. Mohanty P. Jena S. Sirka C. Mishra S. Clinicoepidemiological profile of 590 cases of beetle dermatitis in western Orissa.Indian J Dermatol Venereol Leprol. 2007; 73: 333Crossref PubMed Scopus (10) Google Scholar Early cleansing of the contact site with soap or alcohol helps to remove the canthadrine and may prevent the dermatitis.4James W.D. Berger T.G. Elston D.M. Andrew’s Diseases of the Skin: Clinical Dermatology.11th ed. Saunders Elsevier, Philadelphia2011Google Scholar Acknowledgments: I thank the editorial team of the Wilderness & Environmental Medicine journal for their continuous support to improve this manuscript. I acknowledge Dr OA Oluwasogo and Dr AM Ajao for the permission to use Figure 1 for this article.

An outbreak of blister beetle dermatitis in a residential school: A clinical profile

Background: Blister beetle dermatitis an irritant vesiculobullous disorder caused by rove beetles when it comes in contact with or is crushed on the skin. Their hemolymph consists of pederin, a potent vesicant responsible for the classical morphology of lesions. Materials and Methods: This was a descriptive study of 42 such cases was seen in a residential school, clinical details and photographs were collected using a standard pro forma and consent form, respectively. Results: Clinically, the lesions were present mostly on the uncovered parts of the body (81%). Due to the irritant nature of the lesions, flexures showed classical “kissing lesions.” Only 11.9% (5) cases reported a history of contact with the beetle signifying a high degree of suspicion to make the diagnosis. Conclusion: This article discusses one such outbreak with mention of the clinical profile and preventive methods of Paederus dermatitis.

English

BACKGROUND: Paederus dermatitis (blister beetle dermatitis (BBD) is a geographic seasonal vesiculobullous disorder caused when beetles of the genus Paederus are crushed on the skin, releasing the vesicant pederin. Though blister beetle dermatitis is a clinical diagnosis, at times it becomes difficult to identify it. AIM: To study the clinical profile and factors associated with Paederus Dermatitis/ blister beetle dermatitis (BBD) in patients attending the out-patient department of dermatology of SGT Hospital, Budhera, Gurgaon. METHODS: 100 clinically diagnosed cases of beetle dermatitis were included in the study. The patients were evaluated by means of a standard pro forma which included detailed history and thorough clinical examination. RESULTS: A total of 100 cases were examined of which 67% were males and 33% females. Maximum cases reported in the month of April (25%). 32% patients had more than one lesion with involvement of multiple sites. Face (34.5%) was found to be most commonly involved site. Most of the patients presented with vesicles and bullae on erythematous background arranged in linear fashion. Constitutional symptoms were rarely seen in only 7% of the patients. No mucosal or systemic involvement was found. CONCLUSION: Despite its frequency, the disease is rarely described in medical literature, probably because the correct diagnosis is not made. It is important for the rural population in particular to be aware of this condition and to take adequate measures for its prevention especially during harvesting and rainy

Clinical Presentation of “Rove Beetle Dermatitis”

Objectives: This case series describes new clinical features of Rove beetle dermatitis Methods: Interviews were conducted with four students at University Sains Malaysia with current or past Rove beetle skin infections. Information on the onset of symptoms, complication, treatment and duration of symptoms were recorded. A physician at a local clinic was also interview to describe the challenges in diagnosis and therapy for this condition. Results: This case series describes new features of Rove beetle dermatitis. Redness, swelling, fatigue and localised stretching of the skin were the commonly reported symptoms. However, vibrations, twitching of the skin and difficulty in breathing were new features observed in this study. Three of the four patients were not aware of the aetiology of the condition, antibiotics and topical steroids were prescribed for the management and prevention of secondary infection. Conclusion: Rove beetle dermatitis is a common seasonal endemic in Malaysia, with a higher incidence in the month of September and March. This case series highlights the need for a health literacy program, aimed at informing the public and medical practitioners about the aetiology, symptoms and

Imported Skin Diseases

The foreword to Imported Skin Diseases states, “This book was written and illustrated for the health professional in order to help in the diagnosis and management of patients with diseases acquired in another, often tropical, environment.” The book identifies an important clinical need for practitioners whose patients are traveling to an ever greater degree to more distant and exotic locales. This book is neither an encyclopedic compendium of all tropical skin diseases nor a simple handbook for the house officer or medical student. The breadth of topics is broad, but some topics are discussed in great depth with good authority. The photographic images are clear and well chosen. Chapters that stand out include those on Pigmentary Disorders in Black Skin by J.P.W. van der Veen, M.F.E. Leenarts, and W.W. Westerhof; Coloured versus White Skin by B. Naafs; Buruli Ulcer by F. Portaels and W.M. Meyers; Tungiasis by H. Feldmeier and J. Heukelbach; Myiasis by D.A. Burns; and Beetle Dermatitis by P. Schmid-Grendelmeier and S. Haug. The chapter Persistent Insect Bites by C.L.M. van Hees assumes that all mosquitoes are night biters. The author states that one can prevent mosquito bites by “avoiding being outside from dusk till dawn.” But this message misses the point because anopheline and other species bite from dusk to dawn, and Aedes and other species are day biters. This advice is really intended to help avoid contracting malaria, not being bitten. At times, the writing is puzzling. For example, the chapter, Fever and Rash, by H.G. Schipper and P.A. Kager discusses loiasis and indicates that “fever is absent.” It is unclear why a chapter on fever would include a disease that has no fever. Loiasis is more fully covered in the later chapter, Onchocerciasis/Filariasis, by M. Murdoch, so its discussion in Fever and Rash is superfluous and out of place. Many of the chapters were written by authorities whose first language was probably not English. These chapters could have been edited more carefully because grammatical errors interfere with comprehension. The same applies to the book’s typographical errors, which are too frequent to count. Imported Skin Diseases is organized primarily by diagnosis rather than by syndrome. The disease descriptions are generally complete, with adequate sections on diagnosis and treatment. I discovered at the back of the book, almost by accident, some rather skimpy tables organized by syndrome (fever and rash, ulceration, eschar). I would have preferred this approach to be covered in greater detail because it would be much more useful to the Western practitioner who is confronted with a patient returning from the tropics with an undiagnosed skin disorder. For example, I have a patient in my office with an eschar. The patient has returned from a trip to Africa. What are the diagnostic considerations? Or, a patient has a rash and fever and has traveled widely throughout Asia; how can I approach a proper diagnosis? As the book is written it could be useful as preparation for the Diploma in Tropical Medicine and Hygiene, certification examination of the International Society of Travel Medicine or American Society of Tropical Medicine and Hygiene, or perhaps as a primer for a physician who will travel to the tropics to practice medicine.

Clinicoepidemiological profile of 590 cases of beetle dermatitis in western Orissa

Beetle dermatitis is a very common condition in western Orissa. It is often misdiagnosed and causes significant morbidity among the rural population. This study was conducted to determine the epidemiological and clinical profile of beetle dermatitis in western Orissa. All clinically diagnosed cases of beetle dermatitis were included in the study. Detailed history was taken and thorough clinical examination was conducted in all the cases. One urban and three rural localities were visited regularly to detect the epidemiological trends of the disorder. A total of 590 cases were studied: 486 males and 104 females. The age of the patients ranged from 2 to 65 years. Forty-four percent of the patients belonged to the pediatric age group. Majority of the cases (85%) presented during the months of March to July, indicating a distinct seasonal trend. The disorder was prevalent in the localities nearer to paddy and sugarcane fields and grasslands with stagnant water. The clinical lesions included papules, erosions, crusted lesions, urticarial plaques and vesiculobullous lesions. Distribution was mainly linear, but kissing lesions were also observed. Head, neck and upper extremities were the most commonly involved sites. Lymphadenopathy and systemic features such as fever and malaise were observed in 24% and 15% of the cases, respectively. Beetle dermatitis should be included in the differential diagnosis of the acute onset of vesiculobullous lesions in the endemic areas.

Blistering beetle dermatitis: An outbreak

Background: Blister beetles, which are abundant in Madhya Pradesh and Punjab cause peculiar skin lesions. We came across large number of such cases. Method: This descriptive study comprised 46 cases of Blistering beetle dermatitis who presented to skin OPD, over a period of one month from 17 April to 15 May 2002. Result: All cases belonged to one company of soldiers deployed near an agricultural land. Of the total of 245, 46 personnel suffered from blistering beetle dermatitis with an incidence of 18.7%. A thorough epidemiological investigation was undertaken and beetles of Paederus Fucipes were found incriminating. Further spread was effectively controlled by timely spray of Baygon and Malathion over the infested land. Conclusion: In an outbreak of bizarre dermatitis, diagnosis of blistering beetle dermatitis should be kept in mind. Timely diagnosis, epidemiological investigation and insecticide spraying brings down the incidence of new cases.

Outbreak of rove beetle (Staphylinid) pustular contact dermatitis in Pakistan among deployed U.S. personnel.

Deployed military personnel are often faced with a variety of exposures unfamiliar to U.S. physicians. This is the first report to describe an outbreak of a pustular disease among U.S. personnel deployed to Pakistan in support of Operation Enduring Freedom. Up to 10% of the base population was afflicted with a pustular eruption and an accompanying halo of erythema. A retrospective chart review and ongoing patient care resulted in 191 cases. Various therapies were used, including "watchful waiting." Gradual resolution occurred with residual area(s) of hypo- or hyperpigmentation. An irritant contact dermatitis was suspected based upon clinical presentation; staphylinid (rove) beetles were implicated. Rove beetle dermatitis from a pederin toxin has occurred in other parts of the world but has not been previously reported in Pakistan. We discuss the nature and progression of the dermatitis, treatments, outcomes, measures to control exposures, and the implications of such outbreaks.

Staphylinid blister beetle dermatitis

Staphylinid blister beetle dermatitis

Whiplash rove beetle dermatitis in central Queensland.

Vesicular dermatitis due to contact with Coleoptera (beetles) is common worldwide, although the condition has been infrequently described in Australia. We document the largest outbreak recognized so far in Australia with a conservative estimate of 250 cases. This occurred in central coastal Queensland over several weeks in late 1998. A survey of the medical practitioners in this district is presented, along with clinical and histopathological illustrations. Our research found that knowledge of the condition was limited even in this region where cases occur each year. This condition is an important differential diagnosis in acute blistering disorders.

Staphylinid (Rove) Beetle Dermatitis Outbreak in the American Southwest?

An outbreak of a blistering disease was reported in a military unit training in the Arizona desert during heavy rain and flooding. In a unit of 249 personnel, 33 presented with dermatologic complaints, and 4 met stringent diagnostic criteria for dermatitis linearis. A fifth patient presented with symptoms and signs of "Nairobi eye." Staphylinid (rove) beetles related to the paederids, which have been responsible for vesicular dermatitis outbreaks in other parts of the world but not previously in the United States, were collected at the site. Reports in the antique scientific literature document paederids in the area after periodic floods. These findings suggest that rove beetle dermatitis should be added to the differential diagnosis of vesicular dermatitis in western North America.

Rove beetle (Paederus) dermatitis

Rove beetle (Paederus) dermatitis