Ermira Çuka

Paederus fuscipes dermatitis: a report of nine cases observed in Italy and review of the literature

Paederus sp. is a beetle belonging to Staphylinidae family and Coleoptera order. Its distribution is worldwide, especially in hot climates. Over 600 species of Paederus are known, approximately 50 are able to cause an irritant contact dermatitis. When the beetle is accidentally crushed on the skin, it releases pederin, a potent toxin with vesicating action. In Europe, only anecdotical cases of Paederus sp. dermatitis have been reported. Since 1993, we have observed approximately 25 patients with suspected Paederus sp. dermatitis. In 9 the clinical diagnosis was confirmed because Paederus fuscipes were found. The case list includes 6 males and 3 females, ages ranging from 6 to 53 years (mean age: 26.3 years). Six patients presented with one lesion and 3 with 2 lesions. Eyelids (3 patients), shoulders (3), neck (2), cheek (1), breast (1), back (1) and calf (1) were involved. All patients showed erythema, 2 oedema, 2 blisters, 1 vesicles, 1 pustules and 1 crusts. In the patient with pustules, bacteriological examinations were negative. A biopsy was carried out in 4 patients. In the early stages, spongiosis with exocytosis of neutrophils was observed. Vesicles with neutrophils and necrosis of the epidermis were typical of the advanced stage. Oedema of the dermis and a mixed infiltrate, with eosinophils, neutrophils and lymphocytes, in the papillary and upper reticular dermis, were also observed. Direct immunofluorescence was negative in all patients. Paederus sp. should also be considered in temperate climates as a possible aetiological agent in cases of acute dermatitis.

Scolopendra bites: a report of two cases and review of the literature

Centipedes are arthropods belonging to the class Chilopoda. Approximately 3000 species have been described. Centipedes are found more commonly in tropical and subtropical countries. Centipedes possess venomous fangs. The Scolopendra represent the best‐known genus of centipede.

Presentation of orf (ecthyma contagiosum) after sheep slaughtering for religious feasts

Abstract We report two cases of orf (ecthyma contagiosum) acquired during religious practices. In the first patient, a 34-year-old Muslim man from Tunisia, orf occurred on the left hand after the patient had handled lamb meat during the “Feast of Sacrifice.” In the second patient, a 57-year-old Jewish man, orf was acquired after the “kosherization” of lamb meat and occurred on a finger of the left hand. As approximately 350,000 Muslims reside in the metropolitan area of Milan (Italy), it is possible that in the next future cases of orf acquired after religious practices will occur more often.

Treatment of Sporotrichoid Fish Tank Granuloma with Pulsed Clarithromycin

Background: There is no established therapy of choice for Mycobacterium marinum skin infections; clarithromycin monotherapy was used in some anecdotical cases at changeable daily doses and length. Objective: To evaluate the efficacy and safety of pulsed clarithromycin monotherapy. Methods: 29 patients with a clinical diagnosis of sporotrichoid fish tank granuloma were admitted from 2002 to 2013. In 14 patients, the clinical diagnosis was confirmed by history, histopathology and bacteriological examinations. All patients were treated with clarithromycin (500 mg/day for 10 consecutive days/month for 5 months). Results: In 12 out of 14 patients (85.7%) complete clinical remission was recorded. Two patients showed partial remission after 3 months of therapy, but they were lost to follow-up and were therefore not considered evaluable. Conclusion: Our study suggests that pulsed clarithromycin monotherapy is effective and safe in sporotrichoid M. marinum skin infections.

Staphylococcus aureus infection of the feet following fish pedicure

Abstract We report a case of Staphylococcus aureus infection of the feet that appeared after a “fish pedicure” (immersion of the feet in a tank with the fish Garra rufa, that nibbles off dead skin). Clinical picture was characterized by maceration, purulent discharge, scales, crusts, itching and burning sensation. Bacteriological examinations were positive for Staphylococcus aureus. Mycological examinations were negative. The patient was successfully treated with ciprofloxacin. Only one case of skin foot infection after fish pedicure was reported so far. Fish pedicure can be a potentially dangerous procedure in immunocompromised or diabetic patients.

Cutaneous larva migrans

Cutaneous larva migrans (CLM) is an infestation caused by penetration and migration in the epidermis of larvae of nematodes. Ancylostoma braziliense and Ancylostoma caninum are the species most frequently involved. CLM is characterized by slightly raised and erythematous tracks, very often accompanied by pruritus. CLM can sometimes heal spontaneously; on the other hand, a clinical variety characterized by a very long clinical course has been described. Most used therapies are cryotherapy, topical thiabendazole and oral albendazole and ivermectin.