Montag Andreas, Mebs Dietrich, Oppel Eva
Praxis für Dermatologie und Venerologie, Schweriner Str. 17, 22143, Hamburg, Deutschland.
Institut für Rechtsmedizin, Klinikum der Goethe-Universität Frankfurt a. Main, Frankfurt a. Main, Deutschland.
Hautarzt. 2021 Sep;72(9):805-814. doi: 10.1007/s00105-021-04757-w. Epub 2021 Jan 29.
Beetles of the genus Anthrenus are widespread worldwide and are quite common as grain and stock pests, especially in rural regions and suburban areas. The larvae of the beetles can trigger skin and occasionally mucosal reactions upon contact. The unfamiliar but typical image of "Anthrenus dermatitis" can easily be misinterpreted if beetle larvae are not detected or a causal link with them is not suspected. In the present article, the causes of Anthrenus dermatitis are discussed using as an example the larva of the woolly flower beetle (Anthrenus verbasci). For the examination of allergic causes, a prick-to-prick test with native larval material was performed in a patient and the specific IgE was determined by CAP coupling as well as in addition to a commercially available ImmunoCAP against larvae of a related beetle species. With the help of an immunoblot, an attempt was made to determine the responsible allergens in the native larval tissue. Important anatomical fine structures of the larva of a woolly herb flower beetle were analyzed using scanning electron microscopy to understand functional processes that lead to the clinical picture of Anthrenus dermatitis. Our allergological findings suggest an IgE-mediated, immediate-type allergy.
皮蠹属甲虫在全球广泛分布,作为谷物和家畜害虫相当常见,尤其是在农村地区和郊区。甲虫幼虫接触后可引发皮肤反应,偶尔也会引起黏膜反应。如果未检测到甲虫幼虫或未怀疑其与疾病存在因果关系,那么“皮蠹性皮炎”这种不常见但典型的病症很容易被误诊。在本文中,以毛花皮蠹(Anthrenus verbasci)幼虫为例,探讨了皮蠹性皮炎的病因。为检测过敏原因,对一名患者进行了用天然幼虫材料的点刺试验,并通过CAP偶联法测定了特异性IgE,此外还使用了针对相关甲虫物种幼虫的市售免疫CAP。借助免疫印迹法,试图确定天然幼虫组织中的致敏原。利用扫描电子显微镜分析了毛花草皮蠹幼虫的重要解剖微观结构,以了解导致皮蠹性皮炎临床表现的功能过程。我们的变态反应学研究结果提示这是一种IgE介导的速发型过敏反应。