Clinico-dermatologic patterns of Paederus dermatitis in a teaching hospital, South India

Abstract

Background: Paederus dermatitis (PD) is common skin condition occurring in South India caused due to contact with Rove beetle. It is often misdiagnosed due to wide difference in its presentation. The aim of this study was to describe the clinical, sociodemographic, and environmental condition of patient’s presenting with PD. Methodology: A descriptive study was done among all patients diagnosed of PD at the Dermatology department of a teaching hospital in Trichy, South India, between January and December 2020. A detailed clinical history, examination of the lesion, and systemic examination was done. Patients were followed-up after 1 week to re-assess the lesion. A total of 117 cases were included in the final analysis. Results: The mean age of patients was 24.54 ± 11.8 years. Female were 51% with 84.6% residing in rural area. Majority of the cases presented between January and May. Presence of thick vegetation (85.5%) and sleeping with windows open (60.7%) were found to be the common risk factors. Most patients reported noticing the lesion in the morning with sudden onset associated with redness and tenderness with a bizarre pattern of lesion. Face, neck, and upper extremity were the most affected sites with burning sensation and itching, experienced by 82.1% and 76.1%, respectively. Ocular involvement with peri-orbital odema was seen among 17% of cases. Post-inflammatory pigmentation was present in 92.1% patients. Conclusion: PD present has a varying degree of skin lesions with absence of the typical linear pattern. Knowledge of its presentation is important to avoid misdiagnosis.

Clinicomorphological patterns in an outbreak of paederus dermatitis in patients attending rural tertiary care hospital

“…Similar findings were seen in studies done in Malaysia and in India. [10][11][12] Head and neck was the most common site reported in our study followed by trunk, upper extremity, similar to other studies. [13][14][15][16] Periorbital dermatitis was seen in 13.7% patients, similar to a study done by the Srihari et al, while in a study done by the Gnanaraj et al it was only 4.9%.…”

“…In our study kissing lesions were present in 7.5% patients whereas in other studies 1.6% and 40.2% were noted. 10,14 Most common morphology seen in the current study was erythematous plaques (76.2%) followed by vesicles, pustules, crusts similar to other studies. 10 According to Padhi et al study, papules were the most common morphology observed.…”

“…In a study done by Padhi et al male preponderance was seen but, in our study, and in a study done by Kumaraguru et al female pre-ponderance was seen. 9,10 In the present study, the average age of patients with PD is 24.8 years. The distribution includes 61.25% females and 38.75% males.…”

“…In a study done in Trichy with 117 cases, the mean age was 24.54±11.8 years, females (51%), 85% patients reported vegetations in the surrounding areas, 71% were sleeping with open windows, 45.2% were sleeping on floor. 10 The 31.2% patients had history of contact with insects while in a study done in Egypt only 14% gave history. Most of the patients noticed lesions in the early morning after waking up.…”

“…11,17 Itching, pain, burning sensation were the most common symptoms in our study similar to other studies. 9,10,13 Most common clinical pattern noted was bizarre pattern followed by linear, annular and kissing lesions. In the study conducted by Padhi et al linear pattern was most common.…”