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Dermatite vésicante à Paederus au Cameroun et revue de littérature

Vesicular contact dermatitis due to Paederus in Cameroon and review of the literature

  • Clinique / Clinics
  • Published:
Bulletin de la Société de pathologie exotique

Résumé

La dermatite vésicante due à Paederus est une dermatose de répartition géographique mondiale, mais qui est principalement rencontrée en zone tropicale. Elle est induite par le contact cutané avec la pédérine, substance vésicante et caustique contenue dans l’abdomen de Paederus (Coléoptère: Staphylinidae). Le diagnostic est anamnestique et clinique regroupant des lésions cutanées caractéristiques et le contexte épidémiologique avec la présence de l’insecte. Notre objectif est d’en décrire les caractéristiques cliniques et épidémiologiques de cette dermatite par une étude rétrospective réalisée en fin de saison des pluies, chez des patients ayant consulté à l’Hôpital de Oku dans le nord-ouest du Cameroun et chez des patients recensés au centre médical de l’ambassade de France à Yaoundé pendant la même période. Nous procéderons également pour le lecteur à une revue de la littérature. Dix-neuf patients ont été étudiés, dont plus de la moitié présentaient plus de deux lésions localisées le plus souvent sur les zones découvertes (visage et cou). Un peu moins de la moitié présentaient des réactions secondaires ou des complications, soit locales, soit respiratoires et trois patients ont présenté des lésions périorbitaires. Cette étude confirme la présence de la pédérose au Cameroun dans l’environnement géo-climatique assez inhabituel des montagnes de haute altitude de l’ouest du pays, mais également dans la capitale, Yaoundé, alors que la pédérose est généralement rapportée dans les régions chaudes et humides ou à proximité des cours d’eau. L’évolution clinique est le plus souvent spontanée et favorable et les complications sont rares. La prise en charge doit être locale et l’antibiothérapie réservée aux complications.

Abstract

This irritant blister dermatitis is caused by the genus Paederus whose geographical distribution is worldwide, with a higher incidence in tropical areas. It is induced by direct skin contact with pederin, a blistering and caustic substance found in the abdomen (coelome) of Paederus insects (insect order Coleoptera: family Staphylinidae). The diagnosis is based on the presence of typical clinical features combined with compatible epidemiological features. Our goal is to describe the epidemiological and clinical features of this irritant contact dermatitis in Cameroon through a retrospective study conducted at the end of the rainy season at the Oku Hospital in Northwest Cameroon and to also include cases reported at the medical center of the French Embassy in Yaounde during this same timeframe. In addition, we conducted a literature review of paederus dermatitis. Nineteen patients were included in this study. More than half of the patients presented with more than two lesions predominantly localized to the face or the neck; less than half had complications manifesting as either localized or respiratory reactions and three patients presented periorbital involvement. This study confirms the presence of paederus dermatitis in Cameroon. It is mainly localized in the unusual geoclimatic region of the western high mountains within the country, as well as the usual warm, moist areas of Yaounde. The clinical evolution of this dermatitis is usually one of spontaneous and uneventful resolution with complications being rare. Curative treatment is one of localized topical therapies while oral antibiotic therapy should be reserved for more complicated cases.

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Authors and Affiliations

  1. Centre médico-social de l’Ambassade de France, BP 1616, Yaoundé, Cameroun

    C. Vanhecke

  2. Service des urgences-SMUR, Hôpital Gabriel Martin, 97460, Saint Paul, La Réunion, France

    C. Vanhecke

  3. Evolution, Génomes, Comportement & Ecologie, CNRS, IRD, Universalisé, Université Paris-Saclay, 91198, Gif-sur-Yvette, France

    P. Le Gall

  4. Centre hospitalier universitaire de la Réunion, Hôpital Félix Guyon, Allée des Topazes, CS 11021, 97400, Saint Denis, La Réunion, France

    B. -A. Gaüzère

  5. Centre René Labusquière, institut de médecine tropicale, Université de Bordeaux, 33076, Bordeaux, France

    B. -A. Gaüzère

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  1. C. Vanhecke
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  3. B. -A. Gaüzère
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Correspondence to C. Vanhecke.

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Vanhecke, C., Le Gall, P. & Gaüzère, B.A. Dermatite vésicante à Paederus au Cameroun et revue de littérature. Bull. Soc. Pathol. Exot. 108, 328–336 (2015). https://doi.org/10.1007/s13149-015-0459-9

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