Cutaneous loxoscelism

Zaragoza Fernández M, López Ortiz R, Domínguez Bueno E, Santos Velasco J, Gaviro Gómez M

Loxoscelism is a toxic disease produced by the poison inoculated through the bite of a spider

belonging to the gender Loxosceles (‘brown spider’ or ‘corner spider’). This clinical condition

may appear under two different clinical forms: cutaneous loxoscelism and viscerocutaneous

loxoscelism. In Spain, the species Loxosceles rufescens has been involved in two cases of cutaneous

loxoscelism but not in cases of viscerocutaneous loxoscelism, a much more severe and

potentially fatal disease. The cutaneous loxoscelism begins with a burning and stinging sensation,

which changes gradually either to an edematous form with intense pain and edema,

with better prognosis, or to a more severe form with necrosis, as occurred in the present case,

which finally developed dry gangrene and required the amputation of a finger. Usually, the diagnosis

is clinical. The treatment includes analgesic and antihistaminic drugs, steroid medication,

broad-spectrum antibiotics and dapsone in some of the more severe. The administration

of the serum antivenin is not recommended in our country.

Domínguez Bueno E, Gaviro Gómez M, López Ortiz R, Santos Velasco J, Zaragoza Fernández M