Paederus Dermatitis

The problem of dermatitis is a common dermatological problem that can be seen worldwide. There are many kinds of dermatitis in clinical medicine. The paederus dermatitis is an interesting dermatitis. This kind of dermatitis is caused by poisonous insect[1]. The problematic causative insect that caused paederus dermatitis is called paederus insect[2]. This insect is a kind of bug that can be seen in many areas around the world[2]. This bug is considered a medically important insect[2]. To cause harmful to human being, paederus insect does not bite or sting, but it causes intoxication[3]. Generally, the problem occurs when a human accidentally brush against or crush the beetle over the skin[3]. The paederus insect can secret paederin from coelomic fluid which is considerable toxic and when a human being contacts with paederin, it will result in dermatological problem. The pediarin is a vesicant toxin that can be found in the hemolymph of almost all female paederus insects. The problematic insects can be seen in many countries, especially in tropical countries. The habitat of this insect is the swamp area. Here, the authors report a case of paederus dermatitis presenting to the physician in charge of a health unit in a coastal area (the case visit is in Novermber, 2013). The patient is a 24 years old student living in a dormitory locating in a coastal area about 3 km from the gulf. The area is plenty of swaps. The patient presents with the acute dermatology problem after contact to the paederus insect during sleeping. The patient visited to the clinic on the 2nd day after exposure and the skin problem of the patient is at his right arm which can be described as papulo-pustular lesions on an erythematous base. The patient was treated by wound dressing and local steroid cream paste (prednisolone). In fact, the paederus dermatitis is a dermatological problem that is limited mentioned. According to PubMed search, there are about 70 reports on this problem. The diagnosis of paederus dermatitis is sometimes difficult[3]. The morphology and location of the dermatitis is variable from case to case[3]. The skin lesion is described as “a sudden onset of erythemato-bullous lesions on exposed areas of the body”[3] and can be misdiagnosed as hot liquid or chemical burn[4]. The involvement sites of the patients are usually at the face, neck, shoulders and arms[5], which are concordant with the present case. Also, as seen in the present case, the skin problem is usually observed upon awakening in the morning[5]. The new interesting concern on this skin problem is the changing of the its epidemiology due to seasonal change[6]. In the present case, the concern is on the existence of the problem in this coastal area. The destroying of the mangrove in the coastal area results in many abandoned swaps in the area and it can be the good habitat to the paederus insect. In addition, with increased temperature year by year, the abundance of insects can be expected.