Although many tropical insects carry infectious diseases, cutaneous injury can 
occur by other mechanisms, for example erucism (envenomation by caterpillars) or 
lepidopterism (dermatitis from moths). Pararama is a unique form of erucism seen 
in workers in contact with rubber trees in the Amazon, and it is caused by 
Premolis larvae, resulting in progressive periarticular fibrosis, ankylosis, and 
the loss of articulation. Ants and aquatic insects of the Belostomatidae family 
can cause painful bites and stings. Anaphylactic shock and death can result from 
the venom of bees and wasps. Beetles can cause vesicular dermatitis via 
cantharidin or paederin. Myiasis results from fly larvae (maggots) feeding on 
live or necrotic tissue of humans or other hosts, while New World screwworm fly 
larvae feed only on living tissue and burrow (ie, screw) more deeply when 
attempts are made to remove them. Tungiasis is characterized by very pruritic 
and painful papules and ulcers resulting from a Tunga flea penetrating the 
host's skin. Dermatologists should be able to diagnose and treat the cutaneous 
manifestations of these tropical insects and educate their patients on 
prevention.