(CS13) Unfortunate Kisses from Charlie: A Case Series

Introduction :

Paederus fuscipes, commonly known as Charlie or rove beetle is a small red and black striped winged beetle that is found in Malaysia. The endosymbiont bacteria present on it produces a vesicant chemical paederin which is 15 times more potent that the venom of a cobra. Contact with skin causes presentation ranging from mild dermatitis to more severe vesicles and bullae.

Description  :

Two patients with positive history of contact with Charlie on his lips were treated at our facility. Clinically the lips were swollen, crusted and multiple pustules were seen. One of the patients which was immunosuppressed developed a more severe reaction resulting in the loss of a significant portion of his lip.  Treatment included daily wound debridement and administration of intravenous  antibiotics.

Conclusion:

The thinner stratum corneum on the lips could have resulted in deeper penetration of the toxin paederin which accounts for the severe presentation in this case. Clinicians must be aware that contact with Charlie on the lips can result in severe lip destruction if not treated promptly. As there is no current literature on the effect of Charlie on the perioral tissue, this report will help to shed light on its destructive nature.