Case Report: Paederus Dermatitis in the Returning Traveler

Jacob W. Pierce Department of Internal Medicine, Virginia Commonwealth University Medical Center, Richmond, Virginia;

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Barry Rittman Division of Infectious Disease, Department of Internal Medicine, Virginia Commonwealth University Medical Center, Richmond, Virginia

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Jillian E. Raybould Division of Infectious Disease, Department of Internal Medicine, Virginia Commonwealth University Medical Center, Richmond, Virginia

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Rash in the returned traveler can provide a diagnostic dilemma for clinicians, but a detailed history including epidemiologic exposures can allow prompt diagnosis of etiologies uncommon in the United States. One such disease is Paederus dermatitis, an irritant contact dermatitis related to exposure to the rove beetle characterized by bullous lesions with surrounding erythema. Although cases and outbreaks have commonly been reported throughout the world, they are rarely reported in travelers returning to the United States. Here, we describe a patient who presented to an academic medical center in Virginia after travel to Sierra Leone with clinical presentation including exposure history and histopathology consistent with Paederus dermatitis. Our patient’s clinic course is described in detail including treatment. Usual treatment includes antihistamines, topical steroids, and oral antibiotics, particularly with antimicrobials with activity against Pseudomonas sp. In addition, this case suggests a potential role for oral steroids in the treatment of this condition but further investigation is required. This case demonstrates the importance of considering a patient’s travel and exposure history, as well as having familiarity with disease processes common in other parts of the world that are rarely seen in the United States.

Author Notes

Address correspondence to Jacob W. Pierce, Department of Internal Medicine, Virginia Commonwealth University Medical Center, P.O. Box 980509, Richmond, VA 23298. E-mail: jacob.pierce@vcuhealth.org

Authors’ addresses: Jacob W. Pierce, Department of Internal Medicine, Virginia Commonwealth University Health System, Richmond, VA, E-mail: jacob.pierce@vcuhealth.org. Barry Rittman and Jillian E. Raybould, Division of Infectious Disease, Virginia Commonwealth University Health System, Richmond, VA, E-mails: barry.j.rittmann@vcuhealth.org and jillian.raybould@vcuhealth.org.

The material contained within has not and will not be offered elsewhere for possible publication, as long as it is under AJTMH consideration.

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