Night of the living thrips: an unusual outbreak of Thysanoptera dermatitis

Identifying the etiology of a cutaneous eruption in the setting of an acute cluster outbreak is of utmost importance due to the inherent potential public health impact. The differential diagnosis ranges from innocuous arthropod bites to more concerning causes such as infection, medication reaction, and environmental exposure. We report the simultaneous presentation of 15 US Marines who presented with numerous discrete papular skin eruptions. Subsequent thorough patient evaluation and history, literature review, immunization status reconciliation, entomological assessment, site survey, and skin biopsy were performed. This case series is one of the largest reported to date of a cluster outbreak of a papular dermatitis secondary to bites from thrips (ie, insects of the order Thysanoptera).