Exogenous acral pigmentation induced by coleoptera: an underdiagnosed mimic of severe disease

Area of Science:

• Dermatology
• Toxicology

Background:

• Acral purpura typically indicates severe internal disease.
• Exogenous pigmentation from invertebrates can mimic purpuric lesions.
• Limited data exists on beetles causing hyperpigmentation or purpura-like lesions.

Observation:

• A patient presented with acral purpura-like lesions.
• The lesions were caused by accidental contact with a darkling beetle.
• The diagnosis was complicated by recent drug inhalation and abnormal autoimmunity tests.

Findings:

• The darkling beetle induced exogenous pigmentation, clinically simulating acral purpuric lesions.
• This case expands the known dermatological effects of invertebrate contact.
• Differential diagnosis of purpuric lesions must include environmental exposures.

Implications:

• Clinicians should consider invertebrate exposure when evaluating purpuric lesions.
• Environmental toxicology plays a role in dermatology.
• Further research is needed on beetle-induced skin reactions.