Dermatitis caused by Paederus fuscipes Curt

An 8-year-old boy was brought to the emergency department of our Institute because of a dermatitis localized to the left eye and left cheek. The parents reported that the day before the boy had been playing in the home garden and that the dermatitis suddenly appeared on the same evening. The boy presented with erythema, edema, and small vesicles on the left eyelid; the conjunctiva was reddened with exudation of a serous fluid. On the cheek on the same side a broad erythematous lesion was present; it was moderately edematous, approximately elliptical in shape, and of a color varying from pink to bright red; furthermore, some small erosive lesions were visible (Fig. 1). The patient complained of burning and pruritus. Tzanck smears for herpetic cells were negative. Both microscopic examinations and cultures for bacteria and fungi also proved to be negative. All laboratory tests done were within the normal range. On the basis of the history, clinical data, and negative outcome of the investigations, a tentative diagnosis of dermatitis caused by Paederus was made. This diagnosis was subsequently confirmed on capture of some specimens of Paederus fuscipes Curt. in the patient's garden (Fig. 2). No other insect theoretically involved in the pathogenesis of the dermatitis was found.