A 31-year-old woman of European origin living in rural Sierra Leone developed a faint erythematous lesion on the right forearm at the beginning of the rainy season. Simultaneously, two similar lesions appeared on the chest along the clothing line and on the right eyelid, causing eyelid swelling without any symptoms of conjunctivitis (Fig. 1A–C). Over the course of four days, the lesions on the chest and eyelid subsided, while the lesion on the forearm progressed to a painful erythematous dermatitis (Fig. 1D, E), resembling a lesion caused by exposure to a toxic substance. The skin lesions presented as linear erythematous plaques, with vesicles and bullae appearing at the periphery of the lesion. No systemic symptoms occurred. Pain and inflammation subsided after applying a class III topical corticosteroid.
Fig. 1
Dermatitis linearis. A Secondary erythematous lesions Day 1. B Faint erythematous lesion Day 1. C Erythema and swelling of eyelid. Day 1. Dermatitis on Day 4. E Dermatitis on Day 5. FPaederus beetle collected on site in Masanga, Sierra Leone
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