JAAD ONLINE: IOTADERMA

JANUARY IOTADERMA (#311)

Botryitis cinera is a necrotrophic species of fungus which kills many fruits. In
oeneology it is revered, however, since when certain grapes (the preferred
host) are infected in a particular way they are used to produce ambrosial
wines such as Sauternes and Barsacs. What, then, is botryomycosis?
Robert I. Rudolph, MD, FACP

Answer will appear in the JAAD Online section of the February issue of the Journal.

DECEMBER IOTADERMA (#310)

Question: Dermatology is filled with lots of words ending in ‘‘.us’’, such as
pruritus, chronicus, planus, nitidus, etc. Do you happen to know what
strophulus is?

Answer: Strophulus is an old term, used almost exclusively in the European

dermatology vocabulary, to describe a frequently encountered hypersensi-
tivity reaction caused by the bites of insects such as mites (the most common
assailant), bedbugs, ticks, mosquitoes, flies, and so forth. In America we call
this disease papular urticaria.1-3 There can be only a few, to hundreds,
of ferociously itchy red papular (along with occasional papulovesicular)
lesions, and there are sometimes concurrent hives. The eruption’s clinical
manifestations depend on both the reactivity of the patient’s immune system
to the particular biting insect, as well as the total amount of allergen presented
into the victim. The disease is far more common in the pediatric population
than in adults, and is more prevalent during the summer. It can be chronic,
and clearing with various oral and topical therapies can take many months. If
you have ever had a patient with the insect driven condition you know how
really resistant to therapy it can be! Strophulus is a Late Latin word meaning
(interestingly) countable or uncountable, and the term was also used for a
long time to describe a ‘‘teething rash’’ in infants.

REFERENCES
1. Stingeni L, Bianchi L, Hansel K, et al. Dermatitis caused by arthropods in domestic
environment: an Italian multicentre study. J Eur Acad Dermatol Venereol.
2017;31(9):1526-1533.
2. Nunes Teixeira LA, Serra O, Tavares Torres NR. Prurigo strophulus (concept,
interpretation, therapeutic approach, prevention and clinical studies). Med Cutan
Ibero Lat Am. 1978;6(5-6):272-278.
3. Senol M, Sasmaz S, Ozerol IH. Papular Urticaria. Pediatr Asthma, Allergy Immunol.
2009;12(1). https://doi.org/10.1089/pai.1998.12.15
Robert I. Rudolph, MD, FACP

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