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Erythematous Papular Rash on the Upper Back Area—Diagnosis
Arch Dermatol. 2006;142:1501-1506.
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Diagnosis: Caterpillar dermatitis, or erucism.
MICROSCOPIC FINDINGS AND CLINICAL COURSE
A skin biopsy specimen demonstrated a mild superficial perivascular lymphoeosinophilic infiltrate, consistent with a hypersensitivity reaction, such as to an arthropod bite or infestation. A few histiocytes were also seen. Despite histologic examination of multiple hematoxylin-eosin–stained sections, no caterpillar spines, arthropod parts, or other foreign objects were identified.
Our patient had minimal symptoms at the time of his initial visit (7 days after being stung), so we prescribed twice-daily applications of fluocinonide ointment. He noticed a slight improvement of his condition within 5 days and complete resolution 16 days later.
DISCUSSION
Caterpillar dermatitis, or erucism, may have multiple cutaneous presentations, and the pathologic appearance is typically nonspecific. More than 140 000 different species of lepidopteran insects exist, but very few (0.1%) have been reported to produce an inflammatory reaction that warrants medical attention.1 Although the histologic findings are nonspecific, a range of features have been described, often varying among different species of . . . [Full Text of this Article]
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Erythematous Papular Rash on the Upper Back Area—Quiz Case
Christy M. Williams, Kirsten S. W. Bellucci, Vincent Liu, and Paul Levins
Arch Dermatol. 2006;142(11):1501-1506.
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