Hyperpigmented Macules Caused by Burrowing Bugs (Cydnidae) May Mimic More Serious Conditions.

Burrowing bugs (Cydnidae) are small insects with spiny legs belonging to the order Hemiptera. Their secretions can lead to asymptomatic hyperpigmented macules in humans. The lesions are self-resolving and do not require treatment. Dermatologists should be aware of the clinical presentation of lesions caused by burrowing bugs, as they could be mistaken for several more serious benign and malignant pigmented conditions, leading to misdiagnosis and unnecessary investigations and treatment. In this article, we present a series of cases from the same community to demonstrate the characteristic features of hyperpigmented macules caused by exposure to burrowing bugs.