[Caterpillar dermatitis. An increasing dermatologic problem in warmer regions of Germany]. / Lepidopterismus. Ein zunehmendes Hautproblem in klimatisch wärmeren Regionen Deutschlands.

Caterpillar dermatitis or lepidopterism (Lepidoptera = butterflies) is a toxic-irritant, or rarely allergic, reaction triggered by the release of histamine, thaumetopoein and other kinins from the hairs of butterflies and caterpillars. In Central Europe, the two main causes of caterpillar dermatitis are the oak and pine processionary caterpillar. In addition to cutaneous reactions, patients may develop conjunctivitis, bronchitis and even anaphylactic reactions. We describe the cutaneous aspects of caterpillar dermatitis based on two case reports.

[Hypereosinophilic dermatitis. An overlooked diagnosis?]. / Hypereosinophile Dermatitis. Ein verkanntes Krankheitsbild?

BACKGROUND: The idiopathic hypereosinophilic syndrome is a rare systemic disease characterized by blood and tissue eosinophilia of unknown etiology, in which multiple organs may be affected. In hypereosinophilic dermatitis the only affected organ besides the blood is the skin. PATIENTS: We present a series of seven patients with hypereosinophilic dermatitis who were treated in our hospital between 2002 and 2003. RESULTS: All patients initially showed characteristic, therapy-resistant, polymorphic skin lesions, presenting with a combination of erythematous, pruritic and urticarial papules and plaques. All had blood eosinophilia without evidence of allergic, parasitic or other causes. The histology showed tissue eosinophilia only in half of the cases; the other histological findings were non-specific. We observed a good response to therapy with systemic corticosteroids, dapsone and light therapy, applied as UVA-1 irradiation or as shower photochemotherapy. CONCLUSIONS: The diagnosis "hypereosinophilic dermatitis" should be based primarily on the characteristic clinical picture together with "idiopathic" peripheral eosinophilia, whereas the histological findings are not always indicative. Because of the multiplicity of possible differential diagnoses and the often non-revealing histology, we assume that the diagnosis "hypereosinophilic dermatitis" is often overlooked.