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A–F) Photographs of 6 persons with skin lesions of Pyemotes ventricosus dermatitis. Note the central microvesicles, ulcerations or crusts, and some lesions with the comet sign. D) Lymphangitis-like dermatitis. E, F) Lesions resulting from natural infection of 2 of the investigators.
Source publication
We investigated 42 patients who had unusual pruritic dermatitis associated with a specific clinical sign (comet sign) in 23 houses in southeastern France from May through September 2007. Pyemotes ventricosus, a parasite of the furniture beetle Anobium punctatum, was the cause of this condition.
Contexts in source publication
Context 1
... 2006, we described an outbreak of unusual dermatitis in southeastern France ( 1 ). Patients affected had highly erythematous pruritic macules typical of arthropod bites, sometimes associated with a linear erythematous macular tract that we called the comet sign ( Figure 1). The cause of this outbreak remained unknown. In May 2007, during an entomologic ecoenvironmental investigation conducted inside the homes of some of these patients, we found wooden furniture, which harbored live furniture beetles ( Anobium punctatum ) (Figure 2, panel A), and small amounts of wood dust on the fl oor. Because A . punctatum does not bite humans or cause contact dermatitis ( 2 ), it was not considered as the direct causative agent. However, stereomicroscope examination of the wood dust identi fi ed the mite Pyemotes ventricosus (Figure 2, panel B). Because Pyemotes spp. can cause dermatitis ( 3 ), they were considered as the hypothetical agent causing the eruption. We then conducted an observational and entomologic study of the new cases. From May through September 2007, all patients re- ferred to the dermatology department at Fréjus Hospital (Fréjus, France) with suspected arthropod-bite dermatitis were examined; patients were also checked for the comet sign. Patients were asked about their outdoor activi- ties (walking in the countryside, gardening), homes, and whether they had wooden furniture potentially infested with furniture beetles. Skin eruptions were photographed. Detailed clinical and histologic descriptions of the lesions have been reported ( 1 ). Whenever possible, ecoenvironments (surrounding terrain and home interior) of patients with typical macules associated with the comet sign were investigated. House- hold pets were examined by veterinarians. When worm- holes were found in wooden furniture, A . punctatum was noted as present in the immediate environment. Mites were collected and examined under a stereomicroscope (magni- fi cation ×80). Removal of furniture was recommended if it was infested with A . punctatum . From May through October 2007, 42 patients with typical eruption formed 23 clusters, comprising 1–5 patients each living in the same home. Nineteen patients lived <50 km from Fréjus and 23 were vacationing in this city. Among the 23 homes in the cluster, 14 were entomologi- cally and ecoenvironmentally investigated. A . punctatum (Figure 2, panel A) was found in all 14 homes and P . ventricosus was found in 12 (83%). Females (Figure 2, panel B), some gravid, and rare males were seen. Entomologic investigations outside homes found no evidence of any oth- er insect pests. Veterinarians who examined the 2 pets living in these homes excluded dog ectoparasites. Dermatitis persisted or recurred for weeks in all patients until infested furniture was removed or patients left their homes. Oral prednisone (0.5 mg/kg) rapidly (within 48 hours) attenu- ated the pruritus. One of us (P.D.) volunteered to place P . ventricosus – infested wood dust on 1 cm 2 of abdominal skin under an occlusive bandage for 4 hours. Two negative controls con- sisted of placing uncontaminated wood dust under a bandage and the bandage alone. Twenty-four hours later, an erythematous macular pruritic lesion was observed that lasted for 7 days, but no comet sign developed. No cutaneous reaction was observed under the 2 negative-control bandages. Natural dermatitis also occurred in 2 investigators during collection of ecoenvironmental samples. Typical lesions with the comet sign (Figure 1, panels E and F) developed in these investigators after they touched wood dust and infested furniture (1 of the investigators had only entered a room with infested furniture but had not touched it). Skin scrapings of the investigators did not contain parasites. A skin-biopsy specimen from 1 investigator showed a sub- corneal ulceration but no parasite. Skin lesions were examined dermoscopically (magni fi cation ×40) and showed a microulceration or vesicle in the center of the macule. In contrast, in vivo confocal laser scanning microscopy (CLSM) of a microvesicle from 1 investigator showed an ovoid foreign body with morphologic features suggestive of P . ventricosus (Figure 2, panels C and D). In 2006, we described an outbreak of an unusual dermatitis associated with a speci fi c clinical sign that we called the comet sign ( 1 ). In 2007, similar cases occurred and we demonstrated that the mite P . ventricosus was the causative agent of the condition. P . ventricosus (Newport, 1850) (phylum Arthropoda, class Arachnida, order Acarina, sub- order Prostigmata, family Pyemotidae) is an ectoparasite of arthropod larvae. This mite has been reported to be associated with A . punctatum (De Geer, 1774), the common furniture beetle ( 2 ). This mite was associated with 2 investigators’ macular lesions that were acquired during experimental or natural infection. Natural infestation gave rise to macules frequent- ly associated with the comet sign. We visualized, by using in vivo CLSM, a microvesicle, an ovoid foreign body with morphologic features suggestive of the mite. An entomologic ecoenvironmental investigation found P . ventricosus and its host ( A . punctatum ) in 83% of the patients’ homes investigated. Although Pyemotes spp.–related dermatitis outbreaks have been described, the outbreak we describe showed an emergent pattern with documented intradomi- ciliary infestation and the comet sign. Although Pyemotes spp. have been known since the beginning of the 20th century to cause dermatitis ( 5 ), recent reports are scarce. In all recorded outbreaks, ectoparasites of insect larvae feeding on plants were responsible for dermatitis in workers exposed to agricultural products ( 3 – 7 ). Recent reports of dermatitis caused by Pyemotes spp. are even rarer (14 clinical reports since 1961), which make this dermatitis an almost forgotten disease ( 8 – 13 ). The outbreak was associated with home interior infestations of P . ventricosus associated with A . punctatum. Fine and Scott described the fi rst cases of dermatitis caused by P . ventricosus parasitizing A . punctatum ( 8 ). In Great Britain, Hickin found that up to 60% of woodworm larvae in damp locations were parasitized with Pyemotes spp., which were considered responsible for some skin irritations in woodsmen ( 2 ). More recently, Rodriguez-Casado et al. ( 11 ) described a P . dermatitis outbreak associated with A . punctatum –infested wood desks in a school. Our cases were concentrated from May through September. The fact that we observed most cases in July and August might re fl ect the mite’s life cycle, which is acti- vated when temperatures reach 80°F (26°C) ( 3 ). Moreover, many patients (23/42 in 2007) were on summer vacation, and most of them were living in homes that had been closed for months (i.e., not cleaned regularly), making it likely that the interior mite concentration would be high. Pyemotes spp. dermatitis has been described as a pruritic erythematous rash with maculopapules with a central microvesicle ( 7 ). We initially reported that the typical pruritic erythematous macules were sometimes associated with a linear tract (comet sign) ( 1 ). Several hours after ex- posure, a linear erythematous macular tract arose from patients’ lesions. Whether this sign is speci fi c to Pyemotes spp. or P . ventricosus remains unknown. The epidermis along the linear tract was clinically and histologically intact ( 1 ), thereby making contact dermatitis or epidermal migra- tion of P . ventricosus , as in human scabies, unlikely. In vivo CLSM detected features suggestive of the mite inside the cutaneous microvesicle. A comet sign might represent onset of speci fi c lymphangitis, as suggested for 1 patient (Figure 1, panel D). Two recent similar cases in southern France, which were considered speci fi c atypical lymphangitis ( 14 , 15 ), might have been P . ventricosus ...
Context 2
... 2006, we described an outbreak of unusual dermatitis in southeastern France ( 1 ). Patients affected had highly erythematous pruritic macules typical of arthropod bites, sometimes associated with a linear erythematous macular tract that we called the comet sign ( Figure 1). The cause of this outbreak remained unknown. In May 2007, during an entomologic ecoenvironmental investigation conducted inside the homes of some of these patients, we found wooden furniture, which harbored live furniture beetles ( Anobium punctatum ) (Figure 2, panel A), and small amounts of wood dust on the fl oor. Because A . punctatum does not bite humans or cause contact dermatitis ( 2 ), it was not considered as the direct causative agent. However, stereomicroscope examination of the wood dust identi fi ed the mite Pyemotes ventricosus (Figure 2, panel B). Because Pyemotes spp. can cause dermatitis ( 3 ), they were considered as the hypothetical agent causing the eruption. We then conducted an observational and entomologic study of the new cases. From May through September 2007, all patients re- ferred to the dermatology department at Fréjus Hospital (Fréjus, France) with suspected arthropod-bite dermatitis were examined; patients were also checked for the comet sign. Patients were asked about their outdoor activi- ties (walking in the countryside, gardening), homes, and whether they had wooden furniture potentially infested with furniture beetles. Skin eruptions were photographed. Detailed clinical and histologic descriptions of the lesions have been reported ( 1 ). Whenever possible, ecoenvironments (surrounding terrain and home interior) of patients with typical macules associated with the comet sign were investigated. House- hold pets were examined by veterinarians. When worm- holes were found in wooden furniture, A . punctatum was noted as present in the immediate environment. Mites were collected and examined under a stereomicroscope (magni- fi cation ×80). Removal of furniture was recommended if it was infested with A . punctatum . From May through October 2007, 42 patients with typical eruption formed 23 clusters, comprising 1–5 patients each living in the same home. Nineteen patients lived <50 km from Fréjus and 23 were vacationing in this city. Among the 23 homes in the cluster, 14 were entomologi- cally and ecoenvironmentally investigated. A . punctatum (Figure 2, panel A) was found in all 14 homes and P . ventricosus was found in 12 (83%). Females (Figure 2, panel B), some gravid, and rare males were seen. Entomologic investigations outside homes found no evidence of any oth- er insect pests. Veterinarians who examined the 2 pets living in these homes excluded dog ectoparasites. Dermatitis persisted or recurred for weeks in all patients until infested furniture was removed or patients left their homes. Oral prednisone (0.5 mg/kg) rapidly (within 48 hours) attenu- ated the pruritus. One of us (P.D.) volunteered to place P . ventricosus – infested wood dust on 1 cm 2 of abdominal skin under an occlusive bandage for 4 hours. Two negative controls con- sisted of placing uncontaminated wood dust under a bandage and the bandage alone. Twenty-four hours later, an erythematous macular pruritic lesion was observed that lasted for 7 days, but no comet sign developed. No cutaneous reaction was observed under the 2 negative-control bandages. Natural dermatitis also occurred in 2 investigators during collection of ecoenvironmental samples. Typical lesions with the comet sign (Figure 1, panels E and F) developed in these investigators after they touched wood dust and infested furniture (1 of the investigators had only entered a room with infested furniture but had not touched it). Skin scrapings of the investigators did not contain parasites. A skin-biopsy specimen from 1 investigator showed a sub- corneal ulceration but no parasite. Skin lesions were examined dermoscopically (magni fi cation ×40) and showed a microulceration or vesicle in the center of the macule. In contrast, in vivo confocal laser scanning microscopy (CLSM) of a microvesicle from 1 investigator showed an ovoid foreign body with morphologic features suggestive of P . ventricosus (Figure 2, panels C and D). In 2006, we described an outbreak of an unusual dermatitis associated with a speci fi c clinical sign that we called the comet sign ( 1 ). In 2007, similar cases occurred and we demonstrated that the mite P . ventricosus was the causative agent of the condition. P . ventricosus (Newport, 1850) (phylum Arthropoda, class Arachnida, order Acarina, sub- order Prostigmata, family Pyemotidae) is an ectoparasite of arthropod larvae. This mite has been reported to be associated with A . punctatum (De Geer, 1774), the common furniture beetle ( 2 ). This mite was associated with 2 investigators’ macular lesions that were acquired during experimental or natural infection. Natural infestation gave rise to macules frequent- ly associated with the comet sign. We visualized, by using in vivo CLSM, a microvesicle, an ovoid foreign body with morphologic features suggestive of the mite. An entomologic ecoenvironmental investigation found P . ventricosus and its host ( A . punctatum ) in 83% of the patients’ homes investigated. Although Pyemotes spp.–related dermatitis outbreaks have been described, the outbreak we describe showed an emergent pattern with documented intradomi- ciliary infestation and the comet sign. Although Pyemotes spp. have been known since the beginning of the 20th century to cause dermatitis ( 5 ), recent reports are scarce. In all recorded outbreaks, ectoparasites of insect larvae feeding on plants were responsible for dermatitis in workers exposed to agricultural products ( 3 – 7 ). Recent reports of dermatitis caused by Pyemotes spp. are even rarer (14 clinical reports since 1961), which make this dermatitis an almost forgotten disease ( 8 – 13 ). The outbreak was associated with home interior infestations of P . ventricosus associated with A . punctatum. Fine and Scott described the fi rst cases of dermatitis caused by P . ventricosus parasitizing A . punctatum ( 8 ). In Great Britain, Hickin found that up to 60% of woodworm larvae in damp locations were parasitized with Pyemotes spp., which were considered responsible for some skin irritations in woodsmen ( 2 ). More recently, Rodriguez-Casado et al. ( 11 ) described a P . dermatitis outbreak associated with A . punctatum –infested wood desks in a school. Our cases were concentrated from May through September. The fact that we observed most cases in July and August might re fl ect the mite’s life cycle, which is acti- vated when temperatures reach 80°F (26°C) ( 3 ). Moreover, many patients (23/42 in 2007) were on summer vacation, and most of them were living in homes that had been closed for months (i.e., not cleaned regularly), making it likely that the interior mite concentration would be high. Pyemotes spp. dermatitis has been described as a pruritic erythematous rash with maculopapules with a central microvesicle ( 7 ). We initially reported that the typical pruritic erythematous macules were sometimes associated with a linear tract (comet sign) ( 1 ). Several hours after ex- posure, a linear erythematous macular tract arose from patients’ lesions. Whether this sign is speci fi c to Pyemotes spp. or P . ventricosus remains unknown. The epidermis along the linear tract was clinically and histologically intact ( 1 ), thereby making contact dermatitis or epidermal migra- tion of P . ventricosus , as in human scabies, unlikely. In vivo CLSM detected features suggestive of the mite inside the cutaneous microvesicle. A comet sign might represent onset of speci fi c lymphangitis, as suggested for 1 patient (Figure 1, panel D). Two recent similar cases in southern France, which were considered speci fi c atypical lymphangitis ( 14 , 15 ), might have been P . ventricosus ...
Context 3
... 2006, we described an outbreak of unusual dermatitis in southeastern France ( 1 ). Patients affected had highly erythematous pruritic macules typical of arthropod bites, sometimes associated with a linear erythematous macular tract that we called the comet sign ( Figure 1). The cause of this outbreak remained unknown. In May 2007, during an entomologic ecoenvironmental investigation conducted inside the homes of some of these patients, we found wooden furniture, which harbored live furniture beetles ( Anobium punctatum ) (Figure 2, panel A), and small amounts of wood dust on the fl oor. Because A . punctatum does not bite humans or cause contact dermatitis ( 2 ), it was not considered as the direct causative agent. However, stereomicroscope examination of the wood dust identi fi ed the mite Pyemotes ventricosus (Figure 2, panel B). Because Pyemotes spp. can cause dermatitis ( 3 ), they were considered as the hypothetical agent causing the eruption. We then conducted an observational and entomologic study of the new cases. From May through September 2007, all patients re- ferred to the dermatology department at Fréjus Hospital (Fréjus, France) with suspected arthropod-bite dermatitis were examined; patients were also checked for the comet sign. Patients were asked about their outdoor activi- ties (walking in the countryside, gardening), homes, and whether they had wooden furniture potentially infested with furniture beetles. Skin eruptions were photographed. Detailed clinical and histologic descriptions of the lesions have been reported ( 1 ). Whenever possible, ecoenvironments (surrounding terrain and home interior) of patients with typical macules associated with the comet sign were investigated. House- hold pets were examined by veterinarians. When worm- holes were found in wooden furniture, A . punctatum was noted as present in the immediate environment. Mites were collected and examined under a stereomicroscope (magni- fi cation ×80). Removal of furniture was recommended if it was infested with A . punctatum . From May through October 2007, 42 patients with typical eruption formed 23 clusters, comprising 1–5 patients each living in the same home. Nineteen patients lived <50 km from Fréjus and 23 were vacationing in this city. Among the 23 homes in the cluster, 14 were entomologi- cally and ecoenvironmentally investigated. A . punctatum (Figure 2, panel A) was found in all 14 homes and P . ventricosus was found in 12 (83%). Females (Figure 2, panel B), some gravid, and rare males were seen. Entomologic investigations outside homes found no evidence of any oth- er insect pests. Veterinarians who examined the 2 pets living in these homes excluded dog ectoparasites. Dermatitis persisted or recurred for weeks in all patients until infested furniture was removed or patients left their homes. Oral prednisone (0.5 mg/kg) rapidly (within 48 hours) attenu- ated the pruritus. One of us (P.D.) volunteered to place P . ventricosus – infested wood dust on 1 cm 2 of abdominal skin under an occlusive bandage for 4 hours. Two negative controls con- sisted of placing uncontaminated wood dust under a bandage and the bandage alone. Twenty-four hours later, an erythematous macular pruritic lesion was observed that lasted for 7 days, but no comet sign developed. No cutaneous reaction was observed under the 2 negative-control bandages. Natural dermatitis also occurred in 2 investigators during collection of ecoenvironmental samples. Typical lesions with the comet sign (Figure 1, panels E and F) developed in these investigators after they touched wood dust and infested furniture (1 of the investigators had only entered a room with infested furniture but had not touched it). Skin scrapings of the investigators did not contain parasites. A skin-biopsy specimen from 1 investigator showed a sub- corneal ulceration but no parasite. Skin lesions were examined dermoscopically (magni fi cation ×40) and showed a microulceration or vesicle in the center of the macule. In contrast, in vivo confocal laser scanning microscopy (CLSM) of a microvesicle from 1 investigator showed an ovoid foreign body with morphologic features suggestive of P . ventricosus (Figure 2, panels C and D). In 2006, we described an outbreak of an unusual dermatitis associated with a speci fi c clinical sign that we called the comet sign ( 1 ). In 2007, similar cases occurred and we demonstrated that the mite P . ventricosus was the causative agent of the condition. P . ventricosus (Newport, 1850) (phylum Arthropoda, class Arachnida, order Acarina, sub- order Prostigmata, family Pyemotidae) is an ectoparasite of arthropod larvae. This mite has been reported to be associated with A . punctatum (De Geer, 1774), the common furniture beetle ( 2 ). This mite was associated with 2 investigators’ macular lesions that were acquired during experimental or natural infection. Natural infestation gave rise to macules frequent- ly associated with the comet sign. We visualized, by using in vivo CLSM, a microvesicle, an ovoid foreign body with morphologic features suggestive of the mite. An entomologic ecoenvironmental investigation found P . ventricosus and its host ( A . punctatum ) in 83% of the patients’ homes investigated. Although Pyemotes spp.–related dermatitis outbreaks have been described, the outbreak we describe showed an emergent pattern with documented intradomi- ciliary infestation and the comet sign. Although Pyemotes spp. have been known since the beginning of the 20th century to cause dermatitis ( 5 ), recent reports are scarce. In all recorded outbreaks, ectoparasites of insect larvae feeding on plants were responsible for dermatitis in workers exposed to agricultural products ( 3 – 7 ). Recent reports of dermatitis caused by Pyemotes spp. are even rarer (14 clinical reports since 1961), which make this dermatitis an almost forgotten disease ( 8 – 13 ). The outbreak was associated with home interior infestations of P . ventricosus associated with A . punctatum. Fine and Scott described the fi rst cases of dermatitis caused by P . ventricosus parasitizing A . punctatum ( 8 ). In Great Britain, Hickin found that up to 60% of woodworm larvae in damp locations were parasitized with Pyemotes spp., which were considered responsible for some skin irritations in woodsmen ( 2 ). More recently, Rodriguez-Casado et al. ( 11 ) described a P . dermatitis outbreak associated with A . punctatum –infested wood desks in a school. Our cases were concentrated from May through September. The fact that we observed most cases in July and August might re fl ect the mite’s life cycle, which is acti- vated when temperatures reach 80°F (26°C) ( 3 ). Moreover, many patients (23/42 in 2007) were on summer vacation, and most of them were living in homes that had been closed for months (i.e., not cleaned regularly), making it likely that the interior mite concentration would be high. Pyemotes spp. dermatitis has been described as a pruritic erythematous rash with maculopapules with a central microvesicle ( 7 ). We initially reported that the typical pruritic erythematous macules were sometimes associated with a linear tract (comet sign) ( 1 ). Several hours after ex- posure, a linear erythematous macular tract arose from patients’ lesions. Whether this sign is speci fi c to Pyemotes spp. or P . ventricosus remains unknown. The epidermis along the linear tract was clinically and histologically intact ( 1 ), thereby making contact dermatitis or epidermal migra- tion of P . ventricosus , as in human scabies, unlikely. In vivo CLSM detected features suggestive of the mite inside the cutaneous microvesicle. A comet sign might represent onset of speci fi c lymphangitis, as suggested for 1 patient (Figure 1, panel D). Two recent similar cases in southern France, which were considered speci fi c atypical lymphangitis ( 14 , 15 ), might have been P . ventricosus ...
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Citations
... These mites are often associated with insects infesting indoor environments. In particular they parasitize insects from several orders, including Hemiptera (de Lillo and Porcelli, 1992), Hymenoptera (Bruce and LeCato, 1980;Mahunka and Mahunka-Papp, 1998), Isoptera (Vaivanijkul and Haramoto, 1969), Lepidoptera (Cunha et al., 2006), and various families within Coleoptera (Bianchi et al., 2020;Bruce, 1984;Del Giudice et al., 2008;Vaivanijkul and Haramoto, 1969). Human dermatitis cases caused by mites from the ventricosus group have been reported across several continents, including Europe, Asia, Australia, and the Americas (Bianchi et al., 2020;Broce et al., 2006;Chan et al., 1978;Stingeni et al., 2023). ...
Chemical ecology regarding the ectoparasitoid mite of the family Pyemotidae remains largely underexplored. This field warrants further attention, to enhance the
effectiveness of pyemotid mite species as biological control agents against xylophagous insects and stored-product pests, and to clarify the role of these mites in the onset of itchy dermatitis in humans. This is the first investigation regarding the hostlocation process of Pyemotes tritici (Lagrèze-Fossat and Montane, 1851), an
ectoparasitoid that attacks a wide range of hosts, including xylophagous insects and stored product pests. Bioassays in still air olfactometer and open arena have been performed. Females of P. tritici, consistent with the typical behavior of generalist parasitoids, demonstrated the ability to detect and respond to various volatile chemicals emitted from the host habitat (seasoned wood sawdust from pine and beech) and host frass of two longhorn beetles, Hylotrupes bajulus (L.) and Trichoferus holosericeus (Rossi), as well as from feces and silk of the rice moth Corcyra cephalonica (Stainton), while they did not respond to volatiles emitted from the larvae of the same species. Additionally, they detected non-volatile chemicals from the cuticle of T. holosericeus. These results highlight the importance of chemical cues, both direct and indirect, from the host in the host-location process of P. tritici. Moreover, we provided a useful protocol for safely rearing these potentially harmful mites. Chemical analysis of host and habitat VOCs and host larval CHCs involved in the host location process for identification of active compounds will complete the behavioural results here presented.
... Outbreaks usually end within 1 week (2). Although well-known since the mid-19th century, particularly in workers exposed to agricultural products, foresters, antique dealers, school or house occupants, very few published cases have involved children (5)(6)(7)(8)(9)(10). After a usually painless bite, the patients present with highly itchy lesions consisting of a pinhead-sized central vesicle/urticarial lesion (the site of the mite's bite) surrounded by a rapidly expanding erythematous macule (8). ...
... Cutaneous manifestations can be limited to a single lesion or manifest through multiple aspects (7). When a linear or serpiginous erythematous track called a "comet sign" is present (30% of cases) (2), the diagnosis is oriented toward Pyemotes ventricosus dermatitis and a clinical differentiation with other arthropod bites or stings (2,3,5,9). Usually there is 1 inflammatory track per lesion. The current case is unusual because there were 3 separate tracks, comparable to a "trident" rather than a comet feature. ...
... The current case is unusual because there were 3 separate tracks, comparable to a "trident" rather than a comet feature. The origin of this linear feature has been associated with a specific sign of self-limiting lymphangitis (5,11), while the hypothesis of a parasite migration was excluded by the histological normality of the epidermis along the erythematous track (7). The upper limbs (71%), back (67%), chest and abdomen (56%) are the sites most involved (1). ...
is missing (Short communication)
... One of them is the use of wood treated with chemicals that repel these insects. Additionally, regular maintenance of buildings and furniture, such as applying varnishes and paints, can help prevent infestation [7][8][9][10][11]. ...
... Anobium punctatum (De Geer 1774) (Coleoptera: Anobiidae) [9][10][11]. ...
... 16 on the other hand, species of the ventricosus group have a wide range of hosts, feed on all life stages of their hosts, show homomorphism as adults, and are highly venomous mites: they require only 5 minutes to paralyze their hosts. 10,16,25 the ventricosus group species can attack insect that infest stored foods, 22,23,26 plant pests, 22,23,26 colonies of Hymenoptera (ants, wasps, bees) 19,27 and Isoptera (termites), 26,28 wood-boring beetles that infest work wood or firewood, [29][30][31] and laboratory insect cultures. 10, 25, 32 these mites can accidentally attack humans who stay in infested environments or handle mite infested materials. ...
... 13 Several reports of human dermatitis caused by P. ventricosus species in environments infested with Coleoptera and lepidoptera were reported. 30,31,45,52,55 P. ventricosus shows ectoparasitoid activity on few species of Hymenoptera. 10, 17 furthermore, the morphological taxonomic identification of females (90-95% of the population) is not feasible using the dichotomous keys, because, to date, the criteria to morphologically distinguish female mites belonging to ventricosus group are lacking. ...
... 52 this sign, histologically characterized by normal skin, is a lymphangitic stria which may last up to 2-3 weeks after the bite. 31 an atypical immune response was hypothesized. 52 upper limbs, chest, abdomen, and back are the most frequently involved sites, 12 probably due to their easy exposure to infested woodwork (i.e. ...
The mites of the family Pyemotidae Berlese (1897) are a large family of ectoparasitoids arthropods, known as pathogen for humans since the 18th century and responsible for the so-called "straw itch" or "grain itch" in granary and dock workers. The identified species of the genus Pyemotes are divided into two groups: the scolyti group (P. scolyti, P. parviscolyti and P. dimorphus) and the ventricosus group (P. tritici and P. ventricosus). The first group is characterized by nonvenomous mites usually parasitizing bark beetles; the ventricosus group includes species associated with a large number of hosts (Coleoptera, Lepidoptera, Hymenoptera, Diptera and Rhynchota), parasitizing all host stages, often highly poisonous and responsible for itchy skin lesions for humans. Several species of Pyemotes mites can be pathogenic to humans, especially in spring and summer and in indoor environments, where worm-eaten wood or infested foodstuffs are present. The most frequent clinical feature is the "strophulus," characterized by small erythematous, edematous, and papular lesions centered by a tiny vescicle evolving into a small erosion covered by crust, or by a central hemorrhagic punctum. Other less frequently observed clinical features are urticaria-like lesions, erythematous excoriated papular and pustular lesions, and rarely scabies-like eruptions. The parasitological diagnosis together with the environmental disinfestation and removing of each substrate infested by insects parasitized by Pyemotidae is mandatory to definitely solve Pyemotes dermatitis.
... 7 Comet sign has also been described in infestation with the mite Pyemotes ventricosus which presents as erythematous macules tapering distally with a linear tract resembling a comet, which might herald the onset of lymphangitis. 8 Comet tail lesions are also seen in the fundus of patients with pseudoxanthoma elasticum and are pathognomonic for this condition. These arise earlier than angioid streaks and peau d' orange appearance which are nonspecific. ...
A aerial and Celestial based eponymous review in dermatology
... Pyemotidae is a small family formed by ectoparasitic mites for which insects are the main hosts, although these mites may also parasitize other arthropods. They may also attack humans and other vertebrates, causing dermatitis (Hewitt et al., 1976;Rosen et al., 2002;Del Giudice et al., 2008), fever, dietary disorders, headaches and asthma (Booth & Jones, 1952;Flechtmann, 1973). Cross & Moser (1975) divided Pyemotidae into two groups (scolyti and ventricosus), according to the specificity of the hosts and the biological characteristics of the species. ...
... Although many reports on dermatitis in humans caused by Pyemotes (Figure 2) are associated with Pyemotes herfsi (Oudemans, 1936), Pyemotes tritici (Lagrèze-Fossat & Montagne, 1851) and Pyemotes ventricosus (Newport, 1850) (Fine & Scott, 1965;Moser, 1975;Samsinák et al., 1979;Betz et al., 1982;Del Giudice et al., 2008), Cross & Moser (1975) mentioned P. tritici as the species actually associated with this conditions. In Brazil, Cunha et al. (2006) reported a case of human dermatitis caused by an unidentified species of Pyemotes of the ventricosus group. ...
... Confocal microscopy has also been used to identify other cutaneous parasites [21][22][23][24][25]. Pyemotes ventricosus, an ectoparasite of arthropod larvae invading furniture, presents as an ovoid body of intermediate reflectance inside a cutaneous microvesicle [21]. ...
... Confocal microscopy has also been used to identify other cutaneous parasites [21][22][23][24][25]. Pyemotes ventricosus, an ectoparasite of arthropod larvae invading furniture, presents as an ovoid body of intermediate reflectance inside a cutaneous microvesicle [21]. Cutaneous larva migrans appears as a highly refractile oval or "S" shaped structure within a dark disruption in the normal honeycomb pattern of the epidermis (Figure 5), [22]. ...
... Confocal microscopy has also been used to identify other cutaneous parasites [21][22][23][24][25]. Pyemotes ventricosus, an ectoparasite of arthropod larvae invading furniture, presents as an ovoid body of intermediate reflectance inside a cutaneous microvesicle [21]. ...
... Confocal microscopy has also been used to identify other cutaneous parasites [21][22][23][24][25]. Pyemotes ventricosus, an ectoparasite of arthropod larvae invading furniture, presents as an ovoid body of intermediate reflectance inside a cutaneous microvesicle [21]. Cutaneous larva migrans appears as a highly refractile oval or "S" shaped structure within a dark disruption in the normal honeycomb pattern of the epidermis (Figure 5), [22]. ...
Reflectance confocal microscopy (RCM) is a noninvasive real-time imaging technique that has been widely used for the diagnosis of skin cancer. More recently, it has been reported as a useful tool for the diagnosis and management of several inflammatory and infectious skin disorders. This article provides an overview of the current available applications of RCM use in cutaneous infections and infestations. PubMed was used to search the following terms in various combinations: reflectance confocal microscopy, skin, hair, nail, infection, parasitosis, mycosis, virus, bacteria. All papers were accordingly reviewed. In most cutaneous infections or infestations, the main alterations are found in the epidermis and upper dermis, where the accuracy of confocal microscopy is nearly similar to that of histopathology. The high resolution of this technique allows the visualization of most skin parasites, fungi, and a few bacteria. Although viruses cannot be identified because of their small size, viral cytopathic effects can be observed on keratinocytes. In addition, RCM can be used to monitor the response to treatment, thereby reducing unnecessary treatments.
... 2 The reliability of the 'dust direct examination test to isolate the infesting environmental arthropods' 1 was not questioned, and its feasibility was not compared with 'scanning electron microscopy/in vivo confocal laser scanning'. 1,4,5 In the second letter, we discussed an alternative hypothesis based on anatomic differences: we suggested that 'the mite detected in the described case exhibits features of the Pygmephoridae family, superfamily Pygmephoroidea' and we concluded that 'the exact species of the presented mite has yet to be identified'. The 'Siteroptes (Siteroptoides) species with Pediculaster-like phoretomorphs' were reported only to suggest a possible anatomical similarity. ...
We thank Stingeni et al1 for their comment letter referring to our previous letters.2,3 In the first, we reported on a pediatric non‐atopic patient referred for two itching lesions with targetoid and eczematous appearance after a permanence in a countryside house:2 KOH examination on a skin specimen harvested form the central punctum on scraping revealed the silhouette of an unknown mite. Based on the microscopic pictures, the clinical history and the lesions' morphology, an hypothesis of identification with P.Ventricosus species was first provided.2 The reliability of the “dust direct examination test to isolate the infesting environmental arthropods”1 was not questioned, and its feasibility was not compared with “scanning electron microscopy/in vivo confocal laser scanning”. This article is protected by copyright. All rights reserved.
... The clinical differentiation to other arthropod bite reactions can be made if the characteristic linear or serpiginous erythematous track, called "comet sign", is present. 2 The lesions evolve within 24 hours after contact with P. ventricosus, are self-limited, and typically resolve in 1-3 weeks. Patients may also develop systemic symptoms, such as fever, chills, vomiting, or intense headache. ...
