Mites, caterpillars and moths.

Besides conditions such as scabies and hypersensitivity to house dust mites, other diseases caused by mites and caterpillars tend to be more uncommon in everyday practice. Nevertheless, there is a broad spectrum of medically relevant disorders associated with these arthropods. Mites may act as parasites that infect or colonize the skin (e.g., scabies, pseudoscabies, demodicosis) or they may pierce the host's skin and feed on tissue fluid and blood (trombiculosis). In the latter case, they also play a role as vectors transmitting Orientia tsutsugamushi, the pathogen that causes Tsutsugamushi fever. In addition to house dust mites, storage mites, too, are characterized by their allergenic potential. The terms erucism and lepidopterism are used for the various diseases caused by caterpillars and moths. Both terms are not used consistently. With respect to pathogenesis, various mechanisms have been described, including type I and type IV hypersensitivity as well as irritant and toxin-induced reactions. In Germany, skin reactions following exposure to the hairs of oak processionary caterpillars are particularly common. Extracutaneous manifestations including nausea, vomiting, hemorrhage, arthropathy or even life-threatening reactions have been reported in association with certain exotic species. Some species act as parasites by feeding on blood or tears. As natural silk can cause immediate and delayed-type hypersensitivity reactions, workers in the silk industry may develop allergic asthma, rhinitis, or conjunctivitis. Consumption of silkworm pupae is associated with the risk of food allergy.