Outbreak of Occupational Dermatitis Associated With Pyemotes ventricosus.

IMPORTANCE

Although Pyemotes species have been known to cause dermatitis, recent reports are rare. During the past 30 years, only 3 outbreaks of dermatitis caused by Pyemotes ventricosus have been reported.

OBJECTIVE

To analyze the causative agent of skin changes in employees of a company that produced herbal medicines.

DESIGN, SETTING, AND PARTICIPANTS: This case series includes 18 patients (8 men, 10 women; mean age, 44 years) who contracted unusual dermatitis after an occupational exposure in July and August of 2012 while working for a company that produced herbal medicines. The patients were examined at the Lower Silesia Regional Centre of Occupational Medicine in Wroclaw, Poland.

EXPOSURES

Workers weighed and packed 1 part of the Helichrysum arenarium herb.

MAIN OUTCOMES AND MEASURES

We hypothesized the causative agent to be P ventricosus. An examination of the herbal specimens for ectoparasites confirmed the diagnosis.

RESULTS

Initially 16 employees developed pruritic skin changes. Skin lesions with pruritic vesicles on an erythematous base with surrounding swelling and edema were observed. Several employees also developed a flulike illness. After 44 days, 2 new employees presented with the same skin changes. The analysis of working conditions showed that the same part of the H arenarium herb was weighed and packed at that time.

CONCLUSIONS AND RELEVANCE

We found that changing the time when the herbs were weighed and abandoning gas fumigation containing methyl bromide resulted in the recurrence of an almost forgotten disease.