Cutaneous Loxoscelism.

JAMA Dermatol

Section of Dermatology, Di.S.Sal. Department of Health Science, University of Genoa, San Martino Polyclinic Hospital, Genoa, Italy.

Published: February 2020

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http://dx.doi.org/10.1001/jamadermatol.2019.3252DOI Listing

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Spiders of the genus represent a public health problem in Brazil due to the severity of the cutaneous and systemic effects that may result from their bite. In the systemic form of loxoscelism, hemolytic anemia, thrombocytopenia, and disseminated intravascular coagulation can occur. Despite the seriousness of accidents, the venom of some species has not yet been properly characterized considering these hemotoxic effects, such as that of , , and .

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BACKGROUND Compartment syndrome of the forearm has been associated with a variety of etiologies, including fractures, snake bites, complications of certain infections, and, very rarely, spider bites. Loxoscelism is the venom-related clinical manifestation of the bite of spiders of the genus Loxosceles, also called brown or fiddler (violinist) spiders. It manifests locally/regionally with pain, erythema, and edema, with subsequent necrotic plaque formation at the site of the bite.

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Loxoscelism is the pathological condition triggered by a brown spider bite. The venom of these spiders is rich in phospholipases D (PLDs), which can induce virtually all local and systemic manifestations. Recombinant mutated PLDs from clinically relevant Loxosceles species in South America have been investigated as potential antigens to develop novel therapeutic strategies for loxoscelism.

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Background: Loxoscelism refers to a set of clinical manifestations caused by the bite of spiders from the genus. The classic clinical symptoms are characterized by an intense inflammatory reaction at the bite site followed by local necrosis and can be classified as cutaneous loxoscelism. This cutaneous form presents difficult healing, and the proposed treatments are not specific or effective.

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Necrotic ulcers caused by Loxosceles rufescens bites: a report of seven patients and scanning electron microscopy of the spider.

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June 2024

SC Dermatologia, Fondazione IRCCS, Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.

Article Synopsis
  • Loxosceles rufescens is a spider that can cause bites leading to necrotic ulcers in humans; the study documents twelve cases with confirmed bites and provides detailed clinical observations.
  • Seven patients developed single necrotic ulcers in various body parts, experiencing pain and burning but showing no systemic symptoms; they were treated with topical solutions and some needed antibiotics for bacterial infections.
  • Recovery took up to eight weeks for all patients, but five developed scars, highlighting the need for proper identification of the spider to confirm the bite's causative agent and manage treatment effectively.
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