A healthy young man, upon placing the palm of his hand on a wooden floor, experienced an immediate severe burning sensation. A small black shiny beetle was found lying partially crushed. The initial burning pain in the palm subsided, but a dull discomfort persisted for several hours. Examination revealed two areas of dark yellow-brown discoloration, resembling the colour of iodine, on the palm (Box 1). These measured about 1 × 2 cm, with a surrounding halo of mild erythema. The affected skin had normal texture, markings, and sensation, and no blistering or vesication was seen. The patient remained systemically well throughout the episode. No evidence of external biting, stinging or defensive apparatus was found on inspection. The skin changes lasted 3–4 days, and resolved completely.
Publication of your online response is subject to the Medical Journal of Australia's editorial discretion. You will be notified by email within five working days should your response be accepted.