Pararamosis Associated with the Caterpillar Premolis semirufa

Synonym: pararama-associated phalangeal periarthritis

Moth Species: Premolissemirufa

Name of caterpillar stage: pararama

Pathogenesis: toxins/venom on the hairs of the caterpillar which trigger inflammation and induce degeneration of cartilage with remodeling of the extracellular matrix

Clinical features:

(1) acute reaction, with pain, heat and redness

(2) chronic synovitis primarily affecting the hands, with thickening of the articular synovial membranes and joint deformities