You are correct. Lepidopterism refers to the cutaneous findings after contact w/ caterpillars, but also is seen w/ moths, cocoons, or butterflies. Immediate sx include pain, itching, or burning, followed classically by a “train-track” purpuric eruption. Allergic contact dermatitis to Toxicodendron results in an eczematous/bullous rash w/ a geometric configuration, usually 48h after contact w/ the inciting agent. Although stings from Hymenoptera and bites from Latrodectus or Loxosceles can cause edema and an immediate rash, they would not result in train-track purpura. Latrodectus may cause sx reminiscent of an acute abdomen, and Loxosceles bites may cause necrotizing lesions. In this case, the io moth caterpillar (Automeris io) was discovered in the vicinity of the walking path.

Emergency Medicine Journal 2019;36:696-704.