Assuntos
Hiperplasia do Linfonodo Gigante/diagnóstico , Penfigoide Bolhoso/diagnóstico , Exame de Medula Óssea , Hiperplasia do Linfonodo Gigante/complicações , Hiperplasia do Linfonodo Gigante/terapia , Diabetes Mellitus Tipo 2/complicações , Diagnóstico Diferencial , Eritema Multiforme/complicações , Eritema Multiforme/diagnóstico , Feminino , Humanos , Linfonodos/patologia , Pessoa de Meia-Idade , Gamopatia Monoclonal de Significância Indeterminada/diagnóstico , Gamopatia Monoclonal de Significância Indeterminada/etiologia , Penfigoide Bolhoso/complicações , PrednisonaRESUMO
UNLABELLED: Necrotic arachnidism is the potential cutaneous reaction to spider bite venom. In the United States, members of 7 spider families may be responsible for envenomation sufficiently severe to warrant treatment. Characteristics of several spiders, in particular Loxosceles spiders, whose bite is toxic to humans are described, and diagnostic standards, preventive measures, and treatment options are reviewed. (J Am Acad Dermatol 2001;44:561-73.) LEARNING OBJECTIVE: After the completion of this learning activity, participants should be familiar with the characteristics of several different spider families endemic to the United States. Furthermore, this learning activity should aid in the prevention and diagnosis of spider bites as well as in the classification and treatment of specific bites.
Assuntos
Picada de Aranha , Humanos , Picada de Aranha/diagnóstico , Picada de Aranha/epidemiologia , Picada de Aranha/fisiopatologia , Picada de Aranha/terapiaRESUMO
OBJECTIVE: Our purpose was to review documented Loxosceles reclusa (brown recluse spider) envenomations and to describe the natural history. METHODS: This article is a retrospective review of 19 documented cases seen in a university dermatology clinic. The study included the cases of 11 female and 8 male patients between the ages of 15 and 54 years with documented cases of brown recluse spider bite between 1987 and 1993. Rest, ice compresses, elevation, and prophylactic antibiotics were used in all cases. Fourteen patients received dapsone and 11 received nonsteroidal anti-inflammatory drugs. Two patients were hospitalized. A 3-point scale of cutaneous lesion severity was developed. Analysis of the association between maximum lesion severity (mild, moderate, severe) and time to complete healing or final evaluation was statistically significant (P < .001). RESULTS: All patients presented with localized erythema. Most bites were on the extremities (18/19; 95%). The most common presenting symptom was pain at the bite site (10/19; 53%). Eleven patients (58%) had skin necrosis; 32% of them had areas of necrosis larger than 1 cm(2). Time to healing ranged from 5 days to more than 17 weeks (mean, 5.6 weeks). Average time to healing for grade 3 (severe) lesions was 74 days, for grade 2 (moderate) lesions 22 days, and for grade 1 (mild) lesions 8 days (in patients seen more than once). CONCLUSIONS: Brown recluse spider bites frequently induce necrotic, slowly healing lesions. Maximum lesion severity is a predictor of time to complete healing.
Assuntos
Picada de Aranha , Adolescente , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Picada de Aranha/complicações , Picada de Aranha/diagnóstico , Picada de Aranha/terapiaRESUMO
The bite of the brown recluse spider (BRS) is the most severe arthropod cause of necrotic skin lesions. The severity of cutaneous injury due to BRS bites vary from mild erythema to severe necrosis. Rarely, severe systemic reactions occur. Diagnosis may be difficult, since the victim may not feel the bite or see the spider. Treatment must be individually tailored. Proper treatment, reassurance, and rapid followup are helpful in reducing the cutaneous and psychologic discomfort associated with BRS bites.
