Evacuation of an Aboriginal community in response to an outbreak of blistering dermatitis induced by a beetle (Paederus australis)

A Case Series of Paederus Dermatitis: Understanding Its Varied and Diverse Clinical Presentations

Introduction  Paederus dermatitis arises from inadvertent skin contact with insects of the genus Paederus, leading to irritant contact dermatitis. This study aims to highlight the diverse clinical presentations and the remarkable ability of the disease to mimic various dermatological conditions.  Methodology  A total of 15 patients diagnosed with Paederus dermatitis in a period of four months from August 2023 to November 2023 were included in this retrospective study. The demographic profile, detailed history, clinical presentation, and site of lesion distribution were documented.  Results  Out of 15 patients, nine were males, and eight were females. All patients exhibited a sudden onset of lesions accompanied by burning and pain, with an average duration of approximately 2.5 days. The most prevalent clinical presentation was the linear type, followed by kissing lesions, an erythematous patch with a central gray area, Nairobi eye, burnt appearance, and post-inflammatory pigmentation.  Conclusion  Paederus dermatitis is common in tropical areas like India but is prone to misdiagnosis due to its varied presentation. Increased awareness can lead to accurate diagnoses and simpler treatment plans, reducing patient confusion.

Development of markers using microsatellite loci of two rove beetle species, Paederus fuscipes Curtis and Aleochara (Aleochara) curtula Goeze (Coleoptera: Staphylinidae), followed by analyses of genetic diversity and population structure

BACKGROUND

The family Staphylinidae is the most speciose beetle group in the world. The outbreaks of two staphylinid species, Paederus fuscipes and Aleochara (Aleochara) curtula, were recently reported in South Korea. None of research about molecular markers and genetic diversity have been conducted in these two species.

OBJECTIVE

To develop microsatellite markers and analyze the genetic diversity and population structures of two rove beetle species.

METHODS

NGS was used to sequence whole genomes of two species, Paederus fuscipes and Aleochara (Aleochara) curtula. Microsatellite loci were selected with flanking primer sequences. Specimens of P. fuscipes and A. curtula were collected from three localities, respectively. Genetic diversity and population structure were analyzed using the newly developed microsatellite markers.

RESULTS

The number of alleles ranged 5.727-6.636 (average 6.242) and 2.182-5.364 (average 4.091), expected heterozygosity ranged 0.560-0.582 (average 0.570) and 0.368-0.564 (average 0.498), observed heterozygosity ranged 0.458-0.497 (average 0.472) and 0.418-0.644 (average 0.537) in P. fuscipes and A. curtula, respectively. Population structure indicates that individuals of A. curtula are clustered to groups where they were collected, but those of P. fuscipes are not.

CONCLUSION

Population structures of P. fuscipes were shallow. In A. curtula, however, it was apparent that the genetic compositions of the populations are different significantly depending on collection localities.

Dermatitis linearis outbreak associated with Paederus balcanicus in Austria

Background

Dermatitis linearis is a toxic skin lesion caused by contact with certain beetles of the genus Paederus (Coleoptera: Staphylinidae). Dermatitis linearis outbreaks have been described mainly in tropical and subtropical regions, but so far not in Central Europe, and are considered an emerging public health concern potentially associated with climate change.

Material and methods

Following diagnosis of dermatitis linearis in a cluster of six adults and one child with reported exposure to beetles with morphological characteristics of Paederus species at a recreational public open-air bath at Lake Neusiedl (Illmitz, Burgenland, Austria), we performed on-site inspection and installed light and pitfall traps. Collected beetle specimens of the genus Paederus were classified using morphological characteristics and DNA barcoding.

Results

A total of 32 Paederus beetles were collected using an aspirator (n = 2) and light traps (n = 30). No individuals of the genus Paederus were captured with the pitfall traps. Morphological analyses identified them as members of the Paederus balcanicus species, which was confirmed by genetic specification of four arbitrarily chosen individuals. Dermatitis linearis lesions were treated with topical steroids and healed but partly leaving scars and hyperpigmentation, over the course of a few weeks in all affected persons.

Conclusion

We report for the first time (a) an outbreak of dermatitis linearis associated with exposure to autochthonous Paederus species in Austria, and (b) that contact to the species Paederus balcanicus may cause dermatitis linearis in humans. Adequate measures should be taken to prevent dermatitis linearis outbreaks in areas with resident Paederus occurrence.

Erythroderma and Skin Desquamation in Paederus Dermatitis

Exfoliative erythroderma is rare but serious condition, which requires close supervision. We report a rare case of 28-year-old man with kissing lesions of Paederus dermatitis at his right side of neck. The rash caused by Paederus beetle was improved after treatments. However, the patient developed generalized erythema with desquamation and scaling. The patient was successfully treated topically with moisturizing liquid soap and topical moisturizer with emollients and humectants, and triamcinolone lotion was applied on the bright red lesion. The patient was also treated with oral replacement solution and tropical azelaic cream was applied on the hyperpigmented kissing lesion. This case report shows the importance of a diagnostic practice with follow-up examination.

Ophthalmic manifestations of Paederus dermatitis

PURPOSE

To report the pattern of ophthalmic manifestations associated with Paederus dermatitis (PD).

SETTING

Department of Ophthalmology, Sri Guru Ram Das Institute of Medical Sciences and Research, Amritsar, India.

DESIGN

Clinic-based retrospective study.

METHODS

Medical charts of patients presenting to the eye clinic with clinical features consistent with the diagnosis of PD from May 1, 2014 to April 30, 2016 were retrospectively reviewed. Relevant demographic and clinical data of periocular and ocular findings were collected and analyzed. The patients with a history of chronic skin disorders or allergies were excluded from the study.

RESULTS

A total of 56 patients were included in the study, of which 39 (69.6 %) were males. The age range was 4-65 years with a median of 27 years. On presentation, common subjective symptoms were burning sensation in 49 (87.5 %), itching in 37 (66.1 %), watering in 25 (44.6 %), foreign body sensation in 19 (33.9 %), blurring of vision in 17 (30.4 %), and photophobia in 12 (21.4 %) patients. Visual acuity at presentation was 20/20 in 39 (69.6 %) patients, between 20/30 and 20/80 in 9 (16.1 %) patients, and less than 20/80 in 8 (14.3 %) patients. Lid swelling, erythema, crusts, and vesicles were the common periocular findings; and conjunctival hyperemia, discharge, and corneal erosions were the common ocular findings.

CONCLUSIONS

The current study shows that PD can cause significant ocular morbidity. Ophthalmologists, especially those who work in endemic areas, should be aware of this entity both in terms of management as well as for educating patients about the preventive measures.

[Vesicular contact dermatitis due to Paederus in Cameroon and review of the literature]

This irritant blister dermatitis is caused by the genus Paederus whose geographical distribution is worldwide, with a higher incidence in tropical areas. It is induced by direct skin contact with pederin, a blistering and caustic substance found in the abdomen (coelome) of Paederus insects (insect order Coleoptera: family Staphylinidae). The diagnosis is based on the presence of typical clinical features combined with compatible epidemiological features. Our goal is to describe the epidemiological and clinical features of this irritant contact dermatitis in Cameroon through a retrospective study conducted at the end of the rainy season at the Oku Hospital in Northwest Cameroon and to also include cases reported at the medical center of the French Embassy in Yaounde during this same timeframe. In addition, we conducted a literature review of paederus dermatitis. Nineteen patients were included in this study. More than half of the patients presented with more than two lesions predominantly localized to the face or the neck; less than half had complications manifesting as either localized or respiratory reactions and three patients presented periorbital involvement. This study confirms the presence of paederus dermatitis in Cameroon. It is mainly localized in the unusual geoclimatic region of the western high mountains within the country, as well as the usual warm, moist areas of Yaounde. The clinical evolution of this dermatitis is usually one of spontaneous and uneventful resolution with complications being rare. Curative treatment is one of localized topical therapies while oral antibiotic therapy should be reserved for more complicated cases.

Paederus Outbreaks in Human Settings: A Review of Current Knowledge

Although rove beetles (Paederus spp.) play a beneficial role as biological control agents to manage crop pests in agro-ecosystems, their high prevalence in human settings has elevated them to pest status in urban areas. Rove beetles neither bite nor sting, but accidental crushing on human skin causes them to release the toxin paederin, which causes dermatitis linearis. This review integrates currently available knowledge about the issues pertaining to Paederus infestation. For instance, the results of life history studies conducted under different food and temperature regimes are summarized, as they indicate how large a population can be in a habitat to cause massive and widespread infestation and illustrate the physiological traits required to maintain the population at the maximum level even under adverse conditions. In contrast to what is generally reported, we speculate that climatic factors do not necessarily result in Paederus dispersal in temperate regions; instead, habitat disturbance and site unsuitability may be the main factors that lead to massive dispersal to human settings. Factors such as whether dispersers are adaptable to xeric conditions in human settings, the probability that dispersed Paederus mate with the opposite sex, and whether dispersers have adequate nutrient intake to reproduce are considered to evaluate their potential to reproduce in human settings. Finally, the effectiveness of current commercial insecticides, challenges faced in managing infestations, and sustainable management practices are discussed to provide information for long-term control programs.

Dermatitis linearis: vesicating dermatosis caused by paederus species (coleoptera: staphylinidae). Case series and review

OBJECTIVE

Outbreaks of dermatitis linearis have been documented worldwide. We present a case series of dermatitis linearis from Latin America to highlight the importance of this clinical entity. Clinical, historical, epidemiological, and pathological aspects of the condition are discussed, and a concise current approach to the management and treatment of this morbidity is presented.

METHODS

We present a series of 4 selected cases reflecting the clinical spectrum exhibited in dermatitis linearis by Paederus along with a review of the literature.

RESULTS

In this review we demonstrate the need for awareness of dermatitis linearis as a clinical entity that must be considered in the broad list of differential diagnosis embracing vesicating linear lesions.

CONCLUSIONS

Capture of the insect, epidemiologic features, and a high clinical suspicion can aid in making the correct diagnosis. Primary prevention through public awareness, decreased use of artificial lighting, and mosquito nets can limit the extent and severity of outbreaks.

Life table of Paederus fuscipes (Coleoptera: Staphylinidae)

The life history characteristics of the rove beetle Paederus fuscipes Curtis were studied under laboratory conditions using three field strains from Malaysia: Desa Wawasan (DW), Sri Pinang (SP), and Ampang Jajar (AJ). The total development time of immature stages differed significantly among the three strains, especially between DW (17.43 +/- 0.16 d), SP (18.60 +/- 0.19 d), and AJ (18.68 +/- 0.22 d). Adult females and males from DW also exhibited a shorter life span, although the difference among strains was not significant. In terms of fecundity, the numbers of eggs laid per female for DW, SP, and AJ were 121.28 +/- 15.98, 127.30 +/- 18.01, and 147.45 +/- 17.12, respectively. Additionally, because of the shorter life span in DW strain, two apparent peaks in age-stage specific fecundity were detected. The beetles compensated for their shorter life span by increasing their reproductive activity to sustain the progeny in the population. The intrinsic rates of increase (r) of P. fuscipes from DW, SP, and AJ were 0.0773 +/- 0.0046 d(-1), 0.0788 +/- 0.0051 d(-1), and 0.0873 +/- 0.0054 d(-1), respectively; and the net reproduction rates (R0) were 40.09 +/- 7.39 offspring, 45.29 +/- 8.74 offspring, and 42.34 +/- 8.25 offspring, respectively. The mean generation time of P. fuscipes from AJ was 43.08 +/- 1.07 d, which was significantly higher than that from DW (47.95 +/- 1.36 d) and SP (48.57 +/- 1.43 d). The total immature development time of P. fuscipes in this study was shorter than values reported in previous studies.

Irritant bullous contact dermatitis caused by a rove beetle: an illustrated clinical course

A 26-year-old Australian female traveller in Sierra Leone presented with an irritant bullous contact dermatitis consistent with paederus dermatitis. The lesions were treated with a potent topical corticosteroid with good effect. The affected area resolved in 6 weeks and hyperpigmention persisted for months until complete resolution. This dermatitis occurs when beetles of the genus Paederus (rove beetles) are crushed on the skin, releasing pederin. The same dermatitis ensues with Australian Paederus species. Serial clinical photographs are presented which will aid Australian dermatologists in the diagnosis of this dermatitis, which presents in regional Australian patients and returned overseas travellers.

An outbreak of Paederus dermatitis in a suburban hospital in South India: a report of 123 cases and review of literature

BACKGROUND

Paederus dermatitis is a peculiar irritant contact dermatitis caused when beetles of the genus Paederus (often called rove beetles) are crushed on the skin, releasing the vesicant pederin. The dermatitis is most frequently seen in regions with a hot, tropical climate.

METHODS

We describe 123 patients who presented to our dermatology department at a suburban teaching hospital located in Tamilnadu, South India, known for its long, hot summers. Ours was a 1-year prospective study (January 2005 to December 2005).

RESULTS

The peak time of presentation was during April. The mean duration of lesions before presentation was 2.7 days. The neck and arms were the most common sites of involvement. Male patients outnumbered female patients in our study (males 65%, females 35%). The mean age of patients was 23.4 years. Clinically, the most common presentation consisted of linear, geographic, erythematous plaques with a "burnt" appearance. In 61% of patients, more than one lesion was present. Vesicles were seen in 33.3% of patients and pustules in 4.9% of patients. "Kissing lesions" were seen in 1.6% of patients. Periorbital involvement occurred in 4.9% of patients. The majority of patients were students residing in various hostels in our campus, within 1 km of rice fields.

LIMITATIONS

Species identification of the Paederus beetles was not done. In addition, skin biopsy of the lesions was not done and no histopathologic examination was performed.

CONCLUSION

An outbreak of paederus dermatitis can occur in tropical regions. Awareness of the condition and its clinical features will prevent misdiagnosis. Simple preventive measures can be undertaken based on the behavioral pattern of this nocturnal beetle.

Evidence for a symbiosis island involved in horizontal acquisition of pederin biosynthetic capabilities by the bacterial symbiont of Paederus fuscipes beetles

Pederin belongs to a group of antitumor compounds found in terrestrial beetles and marine sponges. It is used by apparently all members of the rove beetle genera Paederus and Paederidus as a chemical defense against predators. However, a recent analysis of the putative pederin biosynthesis (ped) gene cluster strongly suggests that pederin is produced by bacterial symbionts. We have sequenced an extended region of the symbiont genome to gain further insight into the biology of this as-yet-unculturable bacterium and the evolution of pederin symbiosis. Our data indicate that the symbiont is a very close relative of Pseudomonas aeruginosa that has acquired several foreign genetic elements by horizontal gene transfer. Besides one functional tellurite resistance operon, the region contains a genomic island spanning 71.6 kb that harbors the putative pederin biosynthetic genes. Several decayed insertion sequence elements and the mosaic-like appearance of the island suggest that the acquisition of the ped symbiosis genes was followed by further insertions and rearrangements. A horizontal transfer of genes for the biosynthesis of protective substances could explain the widespread occurrence of pederin-type compounds in unrelated animals from diverse habitats.

Paederus dermatitis in northern Iran: a report of 156 cases

BACKGROUND

Paederus dermatitis develops when beetles of the genus Paederus (often called rove beetles) are crushed on the skin, releasing the vesicant pederin. These beetles are found in many tropical and subtropical habitats.

METHODS

We describe 156 patients who presented to a dermatology clinic in the Guilan province of northern Iran during a 6-month period (May-October 2001).

RESULTS

The peak time of presentation was in September, and the face and neck were the most common sites of involvement. Clinically, the most common presentation comprised geographic erythematous plaques with micropustules. In three-quarters of patients, more than one lesion was present. Kissing lesions were seen in 5% of cases, and 15% of patients developed diffuse desquamation. The majority of patients resided within 1 km of rice fields and used fluorescent lighting at home. In half of the cases, another family member was also affected.

CONCLUSIONS

Paederus dermatitis is a common skin condition in northern Iran. We believe that increased public awareness of this condition can decrease mucocutaneous exposure to pederin.

Clinical toxinology--where are we now?

Clinical toxinology encompasses a broad range of medical conditions resulting from envenomation by venomous terrestrial and marine organisms, and also poisoning from ingestion of animal and plant toxins. Toxin-related disease is an important cause of morbidity and mortality worldwide, particularly in the tropical and subtropical continents. Snake bite is the single most important toxin-related disease, causing substantial mortality in many parts of Africa, Asia, and the Americas. The most important snake families are Viperidae and Elapidae, causing a range of clinical effects including local necrosis, neurotoxicity, coagulopathy and hemorrhage, myotoxicity and renal toxicity. These effects vary according to geography and group of snake. Arachnid envenomation results mainly in morbidity, particularly scorpion stings which can cause severe systemic envenomation. Spider bite is far less of a problem, and the majority of medically important cases can be attributed to widow spiders (Latrodectus spp.) and recluse spiders (Loxosceles spp.). Marine-related envenomations are common, but severe effects are less so. Plant and mushroom poisoning occur in most parts of the world, but the types and methods of poisoning vary considerably between continents. Management of toxin-related disease is often difficult, and in many cases meticulous supportive care is all that is available. The mainstay of treatment is the use of antivenoms for many envenomations and poisoning, although these do not exist for all dangerous organisms. Unfortunately antivenoms are not an economically viable product, so development and manufacture of these agents have been limited. This is now further worsened by a current shortage of antivenom. There is a need for improvement in the preventionand management of toxin-related disease. This will require well-designed studies to define the extent of the problem, initiatives to improve the prevention and management of these conditions, and development of new, and continuation of current, antivenom supplies.

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.