Caterpillar dermatitis

Classification according to ICD-10
L24.8	Toxic contact dermatitis from other agents
ICD-10 online (WHO version 2019)

Caterpillar dermatitis on the arm

The caterpillar dermatitis or erucism is a dermatosis caused by the caterpillars of the processionary moth (Thaumetopoeinae), in Central Europe especially the oak processional moth ( Thaumetopoea processionea ) . The thaumetopoein contained in the stinging hairs of the caterpillars triggers allergic skin reactions.

clinic

Sharply demarcated, light red erythema , urticarial papules and scraped excoriations are found mainly in the area of the exposed skin regions (upper extremities and neck) . The clinical symptoms are described in the literature as lepidopterism ( Lepidoptera = butterflies). These are pseudo-allergic reactions that can be caused by the release of histamine and other kinins : In particular, there is a very itchy, toxic-irritative dermatitis and reactions such as contact urticaria , conjunctivitis , pharyngitis , bronchitis and asthma symptoms , especially in patients with an overly sensitive bronchial system, but general symptoms such as fever and malaise were also described. Individual cases of anaphylactoid reactions through to anaphylactic shock have also been observed.

therapy

Treatment consists of symptomatic therapy with cortisone-containing topicals (i.e., ointments ), ophthalmic topicals, and internal antihistamines . Inhalative beta-mimetics and inhaled corticosteroids are recommended for respiratory problems. Systemic corticosteroid administration is rarely necessary.

prevention

The most important measure is the prevention and the immediate elimination of the caterpillar infestation in residential areas. This points to the great importance of an accurate diagnosis, which then immediately alerts the relevant institutions, e.g. B. must follow the forest management and fire brigade . These initiate the necessary protective measures and carry out the fight: The infected trees are sprayed with insecticides to kill the egg clutches, depending on the season and thus the development phase of the oak processionary moth, the nests are removed and flamed under appropriate protective conditions such as breathing protection and protective suits.

Veterinary medicine

Processionary moth caterpillars are also dangerous for dogs and cats , which sniff the caterpillars out of curiosity or hunt and eat them. This can lead to severe inflammation of the nasal and oral mucosa, which can develop into necrosis of the tongue .

Individual evidence

↑ J. Vega, JM Vega, I. Moneo: Skin Reactions on Exposure to the Pine Processionary Caterpillar (Thaumetopoea pityocampa) In: Actas Dermo-Sifiliográficas (English Edition), Volume 102, Number 9, May 2011, pp. 658-667 . doi: 10.1016 / j.adengl.2011.11.005 . PMID 21545979 .
↑ ^a ^b N. Leitz: caterpillar maitis caused by oak processionary moths. In: Der deutsche Dermatologe , 9, 2003, pp. 684–685.
↑ ^a ^b H. Maier: Poison arrow hail and caterpillar dermatitis. In: Doctors Week. 16, 28, 2002.
↑ ^a ^b T. Rosen: Caterpillar dermatitis. In: Dermatologic Clinics , 8, 1990, pp. 245-252.
↑ ^a ^b ^c J. Utikal u. a .: Caterpillar dermatitis. An increasing dermatologic problem in warmer regions of Germany. In: Der Hautarzt , 60, 2009, pp. 48–50.
↑ S. Grundmann u. a .: Toxic tongue necrosis after contact with caterpillars of the pine processionary moth . ( Memento from February 15, 2016 in the Internet Archive ; PDF; 2.4 MB) In: Kleintierpraxis , 45, 2000, pp. 45–50.
↑ Y. Bruchim, E. Ranen, J. Saragusty, I. Aroch: Severe tongue necrosis associated with pine processionary moth (Thaumetopoea wilkinsoni) ingestion in three dogs. In: Toxicon , Volume 45, Number 4, March 2005, pp. 443-447. ISSN 0041-0101 . doi: 10.1016 / j.toxicon.2004.11.018 . PMID 15733565 .
↑ ME Niza, RL Ferreira, IV Coimbra, HM Guerreiro, NM Félix, JM Matos, TV de Brito, CL Vilela: Effects of pine processionary caterpillar Thaumetopoea pityocampa contact in dogs: 41 cases (2002-2006). In: Zoonoses and Public Health , Volume 59, Number 1, February 2012, pp. 35-38. ISSN 1863-2378 . doi: 10.1111 / j.1863-2378.2011.01415.x . PMID 21824369 .

[1] J. Vega, JM Vega, I. Moneo: Skin Reactions on Exposure to the Pine Processionary Caterpillar (Thaumetopoea pityocampa) In: Actas Dermo-Sifiliográficas (English Edition), Volume 102, Number 9, May 2011, pp. 658-667 . doi: 10.1016 / j.adengl.2011.11.005 . PMID 21545979 .

[Leitz-2] N. Leitz: caterpillar maitis caused by oak processionary moths. In: Der deutsche Dermatologe , 9, 2003, pp. 684–685.

[Maier-3] H. Maier: Poison arrow hail and caterpillar dermatitis. In: Doctors Week. 16, 28, 2002.

[Rosen-4] T. Rosen: Caterpillar dermatitis. In: Dermatologic Clinics , 8, 1990, pp. 245-252.

[Utikal-5] J. Utikal u. a .: Caterpillar dermatitis. An increasing dermatologic problem in warmer regions of Germany. In: Der Hautarzt , 60, 2009, pp. 48–50.

[6] S. Grundmann u. a .: Toxic tongue necrosis after contact with caterpillars of the pine processionary moth . ( Memento from February 15, 2016 in the Internet Archive ; PDF; 2.4 MB) In: Kleintierpraxis , 45, 2000, pp. 45–50.

[7] Y. Bruchim, E. Ranen, J. Saragusty, I. Aroch: Severe tongue necrosis associated with pine processionary moth (Thaumetopoea wilkinsoni) ingestion in three dogs. In: Toxicon , Volume 45, Number 4, March 2005, pp. 443-447. ISSN 0041-0101 . doi: 10.1016 / j.toxicon.2004.11.018 . PMID 15733565 .

[8] ME Niza, RL Ferreira, IV Coimbra, HM Guerreiro, NM Félix, JM Matos, TV de Brito, CL Vilela: Effects of pine processionary caterpillar Thaumetopoea pityocampa contact in dogs: 41 cases (2002-2006). In: Zoonoses and Public Health , Volume 59, Number 1, February 2012, pp. 35-38. ISSN 1863-2378 . doi: 10.1111 / j.1863-2378.2011.01415.x . PMID 21824369 .