Disseminated insect bite reactions in hazelnut workers

Abstract

Background and Design: Hazelnut is one of the most important agricultural products of Turkey. About 150 species of insects were reported in hazelnut orchards. Several skin reactions can be seen in hazelnut workers due to contact with the insects. The objective of this study is to investigate the clinical properties of a type of disseminated insect bite reaction detected in hazelnut workers that has not been reported yet. Materials and Methods: In our study, we investigated patients who presented to our outpatient clinic with disseminated insect bite reactions after entering hazelnut orchards prospectively. Patients’ age, gender, clinical properties of lesions, body areas of involvement, number of lesions, subjective symptoms, duration, blood groups, and prescribed treatments were recorded. The features of the hazelnut orchards were also recorded. Results: One hundred and twenty-seven patients (45 males; 82 females) were included in the study. Mean age of the patients was 42.5±16.69 years. Lesion placements were mostly on the hip (88.2%), leg (78.7%), and back-waist (72.4%) areas. Eighty-five percentage of the patients had violaceous papules, 10.2% showed papular urticaria, and 4.7% with vasculitis-like purpuric papules. Fifty-nine percentage of the patients had between zero and 50 lesions, 28.4% had 50 and 100, and 12.6% of the patients had more than 100 lesions. Severe pruritus was seen in 97.6% of the patients. Conclusion: Insect bite reactions are severe health issues in hazelnut workers. There are limited studies on arthropod-induced dermatoses in hazelnut orchards. However, we demonstrated a novel insect bite reaction pattern of hazelnut workers, which was not defined before in the literature. Defining the condition in the literature and performing further controlled field studies with larger series would help define and prevent the causes of the condition.

Keywords

• insect bites and strings
• vasculitis
• hazelnut