Original Article
Blistering Beetle Dermatitis: An Outbreak

https://doi.org/10.1016/S0377-1237(06)80154-1Get rights and content

Abstract

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.

Introduction

Blistering beetle dermatitis is caused by three groups of beetles of the order Coleoptera [1]. In India they are abundant in Punjab and Madhya Pradesh. Dermatitis is due to an irritating toxic principle in their body fluid which is released when the beetle is crushed, pressed or comes in contact with the skin. The beetles do not bite or sting. The beetles mature in summer and disappear in winters, accounting for a seasonal incidence [2]. We present a descriptive study of 46 cases of blistering beetle dermatitis, occurring among troops deployed in Punjab near an agricultural land.

Section snippets

Material and Methods

The study population comprised of 46 males who presented to the skin OPD of a service hospital with vesicating dermatitis between 17 April and 15 May 2002.

On 17 April 2002, the first three cases presented with bizarre shaped oozing and crusted skin lesions on face, upper extremities and trunk (exposed areas). Sudden onset of stinging and burning often occurred at night, followed by appearance of lesions the next morning. Dermatological examination revealed multiple bizarre shaped, polysized

Results

Of 245 persons deployed in a particular area, 46 (18.7%) developed skin lesions. Age ranged from 20 to 48 years.

The rank wise distribution is given in Table 1. 23 cases (50%) had lesions on the face followed by neck in 32%, trunk 26%, upper extremities 22% and lower extremities 4%. In many cases more than one site were involved. The site wise distribution is given in Table 2.

A total of 16 patients (34.7%) had “kissing lesions” involving the flexures e.g. axillae and cubital fossae. 5 (10.8%)

Discussion

In India blister beetles are abundant in Madhya Pradesh and Punjab. There are more than 30 species belonging to genus Paederus which can cause dermatitis. The important Indian species are Paederus fuscipes, P. irritans, P. sabacus, P. himalayicus, etc. The toxic principle in genus Paederus is pederin pseudopederin and pederone [2, 4].

These beetles are active from May to July. In most of the reported outbreaks from Iran, Turkey, Australia, Malaysia and Sri Lanka maximum cases occurred between

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There are more references available in the full text version of this article.

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