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Caterpillar dermatitis (lepidopterism) is caused by contact to the poisonous hairs (setae) of the pine processionary caterpillars and butterflies. This can lead to irritativ-mechanic, toxic, or allergic reactions, which cannot be clinically differentiated. In Europe the oak processionary caterpillars (Thaumetopoea processionea) and the pine processionary caterpillars (Thaumetopoea pityocampa) are located and causative for the clinical symptoms. Due to climate changes in the recent years there is an increasingly distribution within Germany. Mainly concerned are Berlin, Brandenburg, SaxonyAnhalt, Baden-Wurttemberg, North RhineWestphalia, and Bavaria.