Necrotic ulcers due to bites of Loxosceles rufescens: report of seven patients and scanning electron microscopy of the spider.
background
Loxosceles rufescens This is a spider that can bite humans.
the purpose
Describe the clinical symptoms and treatment of patients with bite injuries. L. rufescens, Then we present scanning electron microscope images of spiders.
Materials and Methods
Twelve patients have been reported, seven of whom had spider samples taken and therefore the etiologic diagnosis was confirmed, and in one case scanning electron microscopy of the spider was performed.
result
Seven patients presented with a single necrotic ulcer of various morphologies with a purulent necrotic bed on the neck (one patient), buttocks (one patient), thigh (one patient), leg (three patients), and foot (one patient). All patients complained of burning and pain. No constitutional symptoms were noted. All patients were treated with sodium hypochlorite solution packs, equine catalase gel, and polyhexamethylene biguanide cream. Oral analgesics were added. One patient was prescribed oral prednisone. Two patients with bacterial superinfection were treated with intravenous piperacillin/tazobactam or intramuscular ceftriaxone. All patients recovered within 8 weeks, but five of six developed scarring.
Conclusion
The sequence of skin symptoms L. rufescens The bite is typical: initially erythema and edema form, followed by vesicles, bullae or pustules, and finally eschar and scarring. Systemic symptoms and signs are rare. To consider this spider as the causative agent of necrotic ulcers, a dead or live spider must be taken and identified by a specialist. Corticosteroids, antibiotics and analgesics are often used. Surgery is often required.
Stefano Verardi, Rossana Sianchi, Gianluca Nazzaro. What causes necrotic ulcers? Loxosceles rufescens Bites: report of seven patients and scanning electron microscopy of spiders. European Journal of Dermatology. 2024;34(3):267-270. doi:10.1684/ejd.2024.4700
