Clinical and Epidemiological Features of Paederus Dermatitis Among Nut Farm Workers in Turkey.

Paederus dermatitis is an acute irritant dermatitis resulting from contact with the hemolymph of Paederus beetles. This dermatitis mimics other infectious skin disorders, often resulting in diagnostic dilemmas. This study of 46 patients was conducted to increase awareness about Paederus dermatitis. Possible causes of a number of cases of Paederus dermatitis in Giresun, Turkey, were investigated using climate data and telephone interviews with the patients about risk factors. Insects caught by patients were identified at the species level. All patients were hazelnut farm workers and admitted to the hospital in the months during which the hazelnut harvesting occurs. Of the patients, 11 (23.91%) presented with painful and burning skin lesions, and 35 (70.09%) complained of itching. The neck was the most involved site (47.83%). The predominant type of lesion was erythematous plaque (84.78%). No pathological findings were detected by laboratory testing. Patients reported coming into contact with the insect during the daytime. Captured insects were identified as Paederus fuscipes. Although the weather and climate were optimal for P. fuscipes during June-October, patients were admitted to the hospital only during the hazelnut harvesting season (August-September). The only risk factor identified among patients was occupation; hence we believe our study is the first to suggest that Paederus dermatitis is an occupational disease among hazelnut farm workers. We suggest that Paederus spp. may become a substantial threat due to global warming, especially among farm workers. Paederus dermatitis is not included in classic medical textbooks. It is necessary to increase awareness about this condition.