title: Cutaneous lepidopterism: dermatitis from contact with moths of Hylesia metabus (Cramer 1775) (Lepidoptera: Saturniidae), the causative agent of caripito itch.
abstract: BACKGROUND
  Lepidopterism derived from contact with arthropods and/or their products can result in adverse reactions that vary in severity from mild irritation to severe reactions including anaphylactic shock and death. Lepidopterism includes cutaneous and/or mucosal manifestations, systemic symptoms, or both mucocutaneous and systemic manifestations.
  
  
  OBJECTIVE
  Epidemic outbreaks of dermatitis due to Hylesia sp. have been recorded in several countries of Latin America. The impact of climatic changes occurring presently on migrational and reproductive cycles of Hylesia metabus is also discussed in this study.
  
  
  METHODS
  In Venezuela, swarms of migrating H. metabus moths are historically recognized as the causative agents of "Caripito itch," a disease that has become an important public health problem.
  
  
  RESULTS
  In this review, we present a series of four case reports reflecting the wide clinical pleomorphism exhibited in lepidopterism by H. metabus.
  
  
  CONCLUSIONS
  Although dermatitis caused by these moths is usually resistant to all therapeutic treatment, individualization of therapy based on symptoms led to successful treatment in all four cases.
authors.affiliation: Department of Pathology and Laboratory Medicine, St Luke's-Roosevelt Hospital Center, New York, NY, USA. albertopaniz@yahoo.com
authors.forename: Alberto E
authors.initials: AE
authors.lastname: Paniz-Mondolfi
authors.forename: Alexandra M
authors.initials: AM
authors.lastname: Pérez-Alvarez
authors.forename: Ulf
authors.initials: U
authors.lastname: Lundberg
authors.forename: Lizette
authors.initials: L
authors.lastname: Fornés
authors.forename: Oscar
authors.initials: O
authors.lastname: Reyes-Jaimes
authors.forename: Marier
authors.initials: M
authors.lastname: Hernández-Pérez
authors.forename: Eric
authors.initials: E
authors.lastname: Hossler
mesh_terms: D000293:Adolescent; D000328:Adult; D000779:Anesthetics, Local / Q000627:therapeutic use; D000818:Animals; D000982:Antipruritics / Q000627:therapeutic use; D002744:Chlorpheniramine / Q000627:therapeutic use; D003877:Dermatitis, Contact / Q000188:drug therapy / Q000209:etiology*; D003907:Dexamethasone / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000627:therapeutic use; D008012:Lidocaine / Q000627:therapeutic use; D017336:Loratadine / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009036:Moths; D011537:Pruritus / Q000188:drug therapy / Q000209:etiology*; D016896:Treatment Outcome; D014222:Triamcinolone Acetonide / Q000627:therapeutic use; D014687:Venezuela
chemical_list: D000779:Anesthetics, Local; D000982:Antipruritics; D002744:Chlorpheniramine; D017336:Loratadine; D003907:Dexamethasone; D008012:Lidocaine; D014222:Triamcinolone Acetonide; D006854:Hydrocortisone