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Clinical manifestations range from toxic\u2013irritant dermatitis and ocular injury to respiratory symptoms, while a subset of exposed individuals develops genuine IgE\u2010mediated disease, including rhinoconjunctivitis, asthma, and rare cases of anaphylaxis. These presentations reflect two mechanistically distinct endotypes: (i) toxin\u2010driven epithelial penetration by the urticating hairs with neuro\u2010inflammatory activation and (ii) allergen\u2010specific sensitisation to defined molecular components such as Tha p 1 and Tha p 2. Accurate endotype differentiation is clinically relevant, as symptom latency, severity, and risk of systemic progression differ substantially. Diagnostic evaluation relies on exposure history and phenotype recognition, complemented in selected cases and experienced centres by skin testing using research\u2010grade extracts and emerging component\u2010resolved approaches. Basophil activation testing may provide additional mechanistic insights in selected cases. Management comprises prompt decontamination, anti\u2010inflammatory therapy, urgent ophthalmologic assessment when eye involvement is suspected, and guideline\u2010based management of anaphylaxis. The environmental persistence of setae and recurrent seasonal exposure highlight the need for improved surveillance, validated molecular diagnostics, and translational research defining immune mechanisms and biomarkers.\n                  <\/jats:p>","DOI":"10.1111\/cea.70415","type":"journal-article","created":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T10:53:43Z","timestamp":1785927223000},"page":"1017-1030","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Processionary Moth Exposure in Europe: Toxic\u2013Irritant and Immunoglobulin E\u2010Mediated Endotypes, Diagnosis and Management"],"prefix":"10.1111","volume":"56","author":[{"given":"Prasad","family":"Dasari","sequence":"first","affiliation":[{"name":"Department of Dermatology, Venereology and Allergology University Medical Center G\u00f6ttingen  G\u00f6ttingen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Josefine","family":"Haas","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Venereology and Allergology University Medical Center G\u00f6ttingen  G\u00f6ttingen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-6712-5717","authenticated-orcid":false,"given":"Wolfgang","family":"Rohe","sequence":"additional","affiliation":[{"name":"Faculty of Natural Resource Management HAWK HHG\u2010University of Applied Sciences and Art  G\u00f6ttingen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kai","family":"Gloyna","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department 3 State Office for Health and Social Affairs Mecklenburg\u2010Vorpommern  Rostock Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christoph","family":"Viebahn","sequence":"additional","affiliation":[{"name":"Institute of Anatomy and Cell Biology University Medical Center G\u00f6ttingen  G\u00f6ttingen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1106-2464","authenticated-orcid":false,"given":"Susann","family":"Forkel","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Venereology and Allergology University Hospital Leipzig  Leipzig Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1553-9765","authenticated-orcid":false,"given":"Michael","family":"Szardenings","sequence":"additional","affiliation":[{"name":"Fraunhofer Institute for Cell Therapy and Immunology Leipzig  Leipzig Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1766-5458","authenticated-orcid":false,"given":"Christine","family":"Stadelmann","sequence":"additional","affiliation":[{"name":"Department of Neuropathology University Medical Center G\u00f6ttingen  G\u00f6ttingen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0698-4130","authenticated-orcid":false,"given":"Michael P.","family":"Sch\u00f6n","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Venereology and Allergology University Medical Center G\u00f6ttingen  G\u00f6ttingen Germany"},{"name":"Lower Saxony Institute of Occupational Dermatology University Medical Center G\u00f6ttingen  G\u00f6ttingen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3139-129X","authenticated-orcid":false,"given":"Timo","family":"Buhl","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Venereology and Allergology University Medical Center G\u00f6ttingen  G\u00f6ttingen Germany"},{"name":"Lower Saxony Institute of Occupational Dermatology University Medical Center G\u00f6ttingen  G\u00f6ttingen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,5]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1146\/annurev-ento-031616-034918"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-94-017-9340-7"},{"key":"e_1_2_11_4_1","unstructured":"T.Sobczyk \u201cDer Eichenprozessionsspinner in Deutschland. 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