Eosinophilic foreign body granuloma after multiple self-administered bee stings

A Foreign Body Granuloma of the Buccal Mucosa Induced by Honeybee Sting

A foreign body granuloma of the buccal mucosa induced by honeybee sting was reported. The patient was an 82-year-old female who presented with a submucous mass at the right buccal mucosa. The mass was 20 mm in diameter, elastically firm, partly mobile without pain or tenderness, and covered with almost normal mucosa. MR image did not delineate the lesion clearly. Under clinical diagnosis of a benign tumor, the lesion was excised under local anesthesia. The excised lesion was 14 × 11 × 9 mm in size and solid and yellowish in cut surface. Histologically, the lesion consisted of granulomatous tissue with a few narrow, curved, eosinophilic structures compatible with decomposed fragments of a honeybee sting and was diagnosed as a foreign body granuloma, although the patient did not recall being stung.

Foreign Body Granulomas

A large list of foreign substances may penetrate the skin and induce a foreign body granulomatous reaction. These particles can enter the skin by voluntary reasons or be caused by accidental inclusion of external substances secondary to cutaneous trauma. In these cases, foreign body granulomas are formed around such disparate substances as starch, cactus bristles, wood splinters, suture material, pencil lead, artificial hair, or insect mouthparts. The purpose of this article is to update dermatologists, pathologists, and other physicians on the most recent etiopathogenesis, clinical presentations, systemic associations, evaluation, and evidence-based management concerning foreign body granulomatous reactions of skin.

Risk associated with bee venom therapy: a systematic review and meta-analysis

OBJECTIVE

The safety of bee venom as a therapeutic compound has been extensively studied, resulting in the identification of potential adverse events, which range from trivial skin reactions that usually resolve over several days to life-threating severe immunological responses such as anaphylaxis. In this systematic review, we provide a summary of the types and prevalence of adverse events associated with bee venom therapy.

METHODS

We searched the literature using 12 databases from their inception to June 2014, without language restrictions. We included all types of clinical studies in which bee venom was used as a key intervention and adverse events that may have been causally related to bee venom therapy were reported.

RESULTS

A total of 145 studies, including 20 randomized controlled trials, 79 audits and cohort studies, 33 single-case studies, and 13 case series, were evaluated in this review. The median frequency of patients who experienced adverse events related to venom immunotherapy was 28.87% (interquartile range, 14.57-39.74) in the audit studies. Compared with normal saline injection, bee venom acupuncture showed a 261% increased relative risk for the occurrence of adverse events (relative risk, 3.61; 95% confidence interval, 2.10 to 6.20) in the randomized controlled trials, which might be overestimated or underestimated owing to the poor reporting quality of the included studies.

CONCLUSIONS

Adverse events related to bee venom therapy are frequent; therefore, practitioners of bee venom therapy should be cautious when applying it in daily clinical practice, and the practitioner's education and qualifications regarding the use of bee venom therapy should be ensured.

Live bee acupuncture (Bong-Chim) dermatitis: dermatitis due to live bee acupuncture therapy in Korea

Live bee acupuncture (Bong-Chim) dermatitis is an iatrogenic disease induced by so-called live bee acupuncture therapy, which applies the honeybee (Apis cerana) stinger directly into the lesion to treat various diseases in Korea. We present two cases of live bee acupuncture dermatitis and review previously published articles about this disease. We classify this entity into three stages: acute, subacute, and chronic. The acute stage is an inflammatory reaction, such as anaphylaxis or urticaria. In the chronic stage, a foreign body granuloma may develop from the remaining stingers, similar to that of a bee sting reaction. However, in the subacute stage, unlike bee stings, we see the characteristic histological "flame" figures resulting from eosinophilic stimulation induced by excessive bee venom exposure. We consider this stage to be different from the adverse skin reaction of accidental bee sting.

Non-allergic Eosinophilic Inflammation

Much is known about the eosinophilic processes associated with antigens, tumors, and infection, yet data on other causes of eosinophilic inflammation are scarce. This paper investigates the locations and causes of other nonrespiratory eosinophilic inflammation. Although eosinophilic inflammation can involve locomotor, urinary, cardiovascular, nervous, gastrointestinal, and other mucosal surfaces, such inflammation also can accompany tissue trauma, foreign-body reactions, and necrotic or granulomatous processes. Despite their cytolytic/histolytic effects, eosinophil leukocytes are a component of tissue remodeling, can be antigen-presenting cells, and have a role in the reproductive system and in blood coagulation. The study of various types of eosinophilic inflammation may increase our understanding of the biological responses of eosinophil leukocytes to different inflammatory stimuli.

Osteochondral destruction in the hand following bee stings: a case report of an infant

We report an infant who developed arthritis with osteochondral destruction in a hand after being stung by bees. The clinical findings resembled those reported as "beekeeper's arthropathy", but the radiological findings were more severe. Histology of the resected specimen revealed fibrous granulation tissue with infiltration of inflammation cells.

Insect sting reactions to bees, wasps, and ants

Abstract Arthropod bites and stings are capable of inflicting injury, inciting allergic reactions, and transmitting systemic disease. Members of the Hymenoptera order are of particular importance because they are nearly ubiquitous in nature, and their stings may cause life-threatening allergic reactions. Stings from bees, wasps, and ants produce a variety of clinical and histological manifestations. Anaphylaxis following an insect sting is the most serious complication. For individuals with a specific allergy to Hymenoptera venom, immunotherapy may be a relatively safe and effective treatment option.