What’s Eating You? Bedbugs
Bedbugs are a known household scourge that also have become an increasing problem in the corporate space. These pests have adapted to the office environment, finding new harborages in which to thrive and devising new ways to obtain blood meals during the day. Bedbugs pose a considerable public health problem, and managing the epidemic will require vigilance by health care professionals as well as patient education on prevention. We present the case of a 42-year-old man with treatment-refractory pruritic papules over the bilateral posterior arms that were attributed to a bedbug infestation at his workplace.
Practice Points
- Bedbug exposures in the workplace are on the rise.
- High clinical suspicion is required when atypical dermatoses are not responding to therapy and histology suggests arthropod exposure.
- Once detected, partnership with occupational health and pest management experts is critical to eradicate bedbugs.
Final Thoughts
Bedbugs continue to remain a nuisance in the home. This case provides an example of bedbugs in the office, a location that is not commonly associated with bedbug infestations. Bedbugs pose numerous psychological, economic, and health consequences.2 Productivity can be reduced, as patients with symptomatic lesions will be unable to work effectively, and those who are unaffected may be unwilling to work knowing their office environment poses a health risk. In addition, employees may worry about bringing the bedbugs home. It is important that employees be educated on the signs of a bedbug infestation and take preventive measures to stop spreading or introducing them to the office space. Due to the scattered habitation of bedbugs in offices, pest control managers need to be vigilant to identify sources of infestation and eradicate accordingly. Clinical manifestations can be nonspecific, resembling autoimmune disorders, fungal infections, or bites from other various arthropods; thus, treatment is highly dependent on the patient’s history and occupational exposure.
Bedbugs have successfully adapted to a new environment in the office space. Dermatologists and other health care professionals can no longer exclusively associate bedbugs with the home. When the clinical and histological presentation suggests an arthropod assault, we must counsel our patients to surveil their homes and work settings alike. If necessary, they should seek the assistance of occupational health professionals.
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