Title: Paederus Dermatitis: A Common but Misdiagnosed and Neglected Entity

Authors: Dr Sandhya Chauhan, Dr Ashok Garg, Dr Prem Lal, Dr Ajay Kumar Ahluwalia, Dr Kuldeep Thakur

 DOI:  https://dx.doi.org/10.18535/jmscr/v5i7.155

Abstract

Background: Paederus dermatitis is a peculiar type of irritant dermatitis induced by vesicant released from rove beetles. The characteristic erythematobullous lesions are produced due to crushing of beetles, not by sting or bite. This disease is prevalent in tropical and subtropical regions.

Methods: A total of 75 cases were enrolled for this study over a period of four months. All clinico-epidemiological parameters were recorded and photographs were taken.  Our aim was to know the clinico-epidemilogical profile of the disease and to sensitize the general practitioners about this commonly misdiagnosed entity.

Results: A total of 75 cases including 32(42%) males and 43(57.3%) females were studied. Affected age ranged from 3 to 64 years. Almost all age groups were involved but 15-30 years age group was most commonly affected. All affected patients were inhabitants of localities lying nearby to Satluj River. All localities were surrounded by abundant vegetation. Majority of the patients presented in the month of September and August. Face, neck and forearms were most commonly affected sites. Most of the patients presented within 48-72 hours of lesion onset. Apart from sudden development of lesion, burning and mild itching were main chief complaints of the patients. Linear pattern was the most common morphology but kissing, bizarre, geographic and whiplash like patterns were also observed. Despite being a common problem 33.3% non-dermatologists were unaware about the disease. Most of the practitioners were misdiagnosing and treating this entity for herpes simplex, herpes zoster, burns and irritant dermatitis.

Conclusion: Paederus dermatitis is common but neglected and misdiagnosed entity. This study describes the clinicoepidemilogical profile along with simple preventive measures for paederus dermatitis. Clinical awareness is recommended for non-dermatologists to avoid misdiagnosis.

Keywords: Paederus dermatitis, Beetle, Paederin, Misdiagnosis.

References

1.      Mammino JJ. Paederus Dermatitis An Outbreak on a Medical Mission Boat in the Amazon. J Clin Aesthet Dermatol 2011;4(11):44-46.

2.      Zargari O, Kimyai-Asadi A, Fathalikhani F, Panahi M. Paederus dermatitis in northern Iran: a report of 156 cases. International Journal of Dermatology 2003;42:608-612.

3.      Ali A, Sujitha K,  Devika T, Sivasankaran MP, Balan K, Praveen Kumar GS, et al. A Study on Paederus Dermatitis Outbreak in a Suburban Teaching Research Hospital, Kanchipuram, India.  Medicine Science 2013;2(3):764-9.  

4.      Iserson KV, Walton EK.  Nairobi Fly (Paederus) Dermatitis in South Sudan: A Case Report. Wilderness & Environmental medicine 2012;23: 251-254.

5.      Nasir S, Akram W, Khan RR, Arshad M, Nasir I. Paederus beetles: the agent of human dermatitis. Journal of Venomous Animals and Toxins including Tropical Diseases 2015; 21:5.

6.      Taneja A, Nayak S, Shenoi SS. Clinical and epidemiological study of Paederus dermatitis in Manipal, India. Journal of Pakistan Association of Dermatologists 2013;23(2):133-138.

7.      Chauhan V, Saroha G, Thakur S, SharmA R. Profile of ‘Paederus Dermatitis Outbreak’ in Boys Hostel of a Rural Medical College in the North India. JAPI 2013;61.

8.      Heo CC, Latif B, Hafiz WM, Zhou HZ. Dermatitis caused by paederus fuscipes Curtis, 1840 (coleoptera: staphilinidae) in Student hostels in selangor, Malaysia. Southeast Asian J TropMed Public Health 2013;44:2.

9.      Handa F, Sharma P, Gupta S. Beetle dermatitis in Punjab (a study of 77 cases). Indian J Dermatol Venereol Leprol 1985;51(4):208-12.

10.  Mittal A, Mehta S, Garg A, Gupta L, Kuldeep CM, Khare AK, Nistha S. A Study of Beetle Dermatitis. Indian Journal of Clinical Practice 2013;23:11.

11.  Singh G, Ali SY. Paederus dermatitis. Indian J Dermatol Venereol Leprol 2007;73:13-5.

12.  Glemetti C, Grimalt R. Paederus dermatitis: an easy diagnosable but misdiagnosed eruption. Eur J Pediatr1993;152:6-8.

13.  Monthei D, Mueller S, Lockwood J, Debboun M. Entomological terrorism: a tactic in asymmetrical warfare. U S Army Med Dept J 2010:11-21.

14.  Yasri S, Wiwanitkit V. Paederus dermatitis. Journal of Coastal Life Medicine 2014;2:16.

Corresponding Author

Dr Sandhya Chauhan

Address: House no. 35, Ward no. 2, Village Anukalan, PO/Teh/ Distt. Hamirpur (HP)

Email: This email address is being protected from spambots. You need JavaScript enabled to view it. Contact: 9459373371, 9817059771