A study on the clinical manifestations in lepidopterism

Exposure to hairs of caterpillars and moths are collectively termed as lepidopterism. Clinical manifestations include cutaneous presentation of localized stinging reaction with wheals or vesiculation, acute urticarial papules and plaques, ophthalmic, oropharyngeal involvement to severe life-threatening anaphylactic reactions with angioedema.

In this study we have determined the prevalence of various cutaneous, oropharyngeal and ophthalmic manifestations of lepidopterism at a tertiary health care center.

All clinically diagnosed cases of lepidopterism were recruited for the study. Characteristics such as age, sex, history of atopy, presence of direct contact with implicated moth/ caterpillar, symptoms and signs, eye, oropharyngeal involvement and systemic findings were noted. Severity of symptoms and signs were quantified according to the Investigator Global Assessment Scale for Dermatitis. Treatment response were noted. The data was analysed and results tabulated.

Out of 32 patients 26 had direct exposure and 6 reported symptoms without direct exposure, Itch and pain, urticaria and excoriations were the most common findings, systemic symptoms though less in occurrence were noted.

There is lack of sufficient literature on these findings for comparative analysis.

Caterpillar dermatitis can occur without direct contact and can be treated completely thus an astute index of suspicion is essential for prompt diagnosis and treatment.