[Anthrenus dermatitis : Case report with suggestions regarding causes and consequences]

Beetles of the genus Anthrenus are widespread worldwide and are quite common as grain and stock pests, especially in rural regions and suburban areas. The larvae of the beetles can trigger skin and occasionally mucosal reactions upon contact. The unfamiliar but typical image of "Anthrenus dermatitis" can easily be misinterpreted if beetle larvae are not detected or a causal link with them is not suspected. In the present article, the causes of Anthrenus dermatitis are discussed using as an example the larva of the woolly flower beetle (Anthrenus verbasci). For the examination of allergic causes, a prick-to-prick test with native larval material was performed in a patient and the specific IgE was determined by CAP coupling as well as in addition to a commercially available ImmunoCAP against larvae of a related beetle species. With the help of an immunoblot, an attempt was made to determine the responsible allergens in the native larval tissue. Important anatomical fine structures of the larva of a woolly herb flower beetle were analyzed using scanning electron microscopy to understand functional processes that lead to the clinical picture of Anthrenus dermatitis. Our allergological findings suggest an IgE-mediated, immediate-type allergy.