Blister beetle bites: a case report
- Authors: Olisova O.Y.1, Teplyuk N.P.1, Tavitova A.R.1, Shamilova L.F.1
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Affiliations:
- I.M. Sechenov First Moscow State Medical University (Sechenov University)
- Issue: Vol 24, No 4 (2021)
- Pages: 387-394
- Section: DERMATOLOGY
- URL: https://rjsvd.com/1560-9588/article/view/78255
- DOI: https://doi.org/10.17816/dv78255
- ID: 78255
Cite item
Abstract
Contacts with insects of the order coleoptera of the families Meloidae and Oedemeridae, in particular the bites of the abscess beetle, lead to acantholysis and the formation of intraepidermal blisters, as well as nonspecific skin damage. The family Meloidae (true abscess beetles) are distributed almost everywhere, with the exception of the territories of New Zealand, Antarctica and the Polynesian islands.
Insect species of the Meloidea family have a unique life cycle. Meloidae females lay eggs not only on coleoptera larvae, but also on any other insects, such as crickets, mantises, wasps, bees, on which their metamorphosis continues in the future. Populations of abscess beetles number a large number of individuals, which increases the risk of their meeting with humans. These species have a highly toxic colorless and odorless poison of non-protein nature ― cantharidin.
There is a rare clinical case of an abscess beetle bite. The debut of the disease occurred at the time of the patient’s trip to the island of Goa (India), where he noted insect bites with the appearance of the first blistering rashes and further progression of the skin process. The primary diagnosis was complicated by nonspecific changes detected during the pathomorphological examination of the skin, in the form of subacute dermatitis without classical manifestations of acantholysis with intradermal blisters due to delayed biopsy appointment. Against the background of ongoing treatment (prednisone; corrective therapy with potassium, magnesium, calcium, gastroprotectors; antibiotics; nonsteroidal anti-inflammatory and antimycotic drugs; combined topical glucocorticoids; a course of systemic autohemoozonotherapy) from the skin process, positive dynamics was noted in the form of relief of inflammatory phenomena, partial epithelization of wound defects.
Secondary infection of rashes, accompanied, as in this case, by abscessing, is often found with bites of various insect families: cases up to the development of necrotic fasciitis with a fatal outcome are described.
The described case is of clinical, scientific and epidemiological interest due to the isolated publications on this nosology and the complexity of diagnosis. Knowledge of the clinical picture of the disease will allow practitioners to develop tactics for managing patients with timely selection of effective therapy.
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About the authors
Olga Yu. Olisova
I.M. Sechenov First Moscow State Medical University (Sechenov University)
Author for correspondence.
Email: olisovaolga@mail.ru
ORCID iD: 0000-0003-2482-1754
SPIN-code: 2500-7989
MD, Dr. Sci. (Med.), Professor
Russian Federation, MoscowNatalia P. Teplyuk
I.M. Sechenov First Moscow State Medical University (Sechenov University)
Email: teplyukn@gmail.com
ORCID iD: 0000-0002-5800-4800
SPIN-code: 8013-3256
MD, Dr. Sci. (Med.), Professor
Russian Federation, MoscowAlana R. Tavitova
I.M. Sechenov First Moscow State Medical University (Sechenov University)
Email: alatavitova@mail.ru
ORCID iD: 0000-0003-1930-0073
Graduate Student
Russian Federation, MoscowLyaman F. Shamilova
I.M. Sechenov First Moscow State Medical University (Sechenov University)
Email: lyaman.doc@gmail.com
ORCID iD: 0000-0002-7271-3910
Graduate Student
Russian Federation, MoscowReferences
- William D, James MD, Elston MD, et al. Andrews’ diseases of the skin: clinical dermatology. 13th Edition. 2019.
- Ghoneim KS. Human dermatosis caused by vesicating beetle products (Insecta), cantharidin and paederin: an overview. World J Med Med Sci. 2013;1:1–26.
- Bertaux B, Prost C, Heslan M, Dubertret L. Cantharide acantholysis: endogenous protease activation leading to desmosomal plaque dissolution. Br J Dermatol. 1988;188(2):157–165. doi: 10.1111/j.1365-2133.1988.tb01769.x
- Al-Basheer M, Hijazi M, Dama T. Blister beetles dermatosis: a report of 43 cases in a military unit in Eritrea. J R Med Serv. 2002;9:40–43.
- Aoun O, François M, Demoncheaux JP, et al. Morning blisters: cantharidin-related Meloidae burns. J Travel Med. 2018. Vol. 25, N 1. Р. 45. doi: 10.1093/jtm/tay045
- Moed L, Shwayder TA, Chang MW. Cantharidin Revisited: a blistering defense of an ancient medicine. Arch Dermatol. 2001;137(10):1357–1360. doi: 10.1001/archderm.137.10.1357
- Karras DJ, Farrell SE, Harrigan RA, et al. Poisoning from «Spanish fly» (cantharidin). Am J Emerg Med. 1996;14(5):478–483. doi: 10.1016/S0735-6757(96)90158-8
- Fernando DM, Kaluarachchi CI, Ratnatunga CN. Necrotizing fasciitis and death following an insect bite. Am J Forensic Med Pathol. 2013;34(3):234–236. doi: 10.1097/PAF.0b013e3182a18b0b
- Lederman ER, Weld LH, Elyazar IR, et al. GeoSentinel surveillance network. Dermatologic conditions of the ill returned traveler: an analysis from the GeoSentinel Surveillance Network. Int J Infect Dis. 2008;12(6):593–602. doi: 10.1016/j.ijid.2007.12.008