Small pests can cause big skin problems
Life-threatening arthropod attacks are rare, but proper diagnosis and treatment are instrumental
Denver — Reactions to arthropod attacks can range from minor skin manifestations to life-threatening situations, an expert says.
Some arthropods’ bark is bigger than their bite, says Julian Trevino, M.D., professor of dermatology at Boonshoft School of Medicine at Wright State University, Dayton, Ohio. Dr. Trevino spoke at the annual meeting of the American Academy of Dermatology.
Due to misidentification and misinformation, he explains, the number of encounters, bites and deaths attributed to brown recluse spiders (Loxosceles reclusa) and other arthropod encounters is greatly exaggerated.
Brown recluse bites generally resolve in one to two months with proper wound treatment, he says, although 10 to 15 percent of cases result in severe scarring. Additionally, Dr. Trevino says, emergency department physicians commonly misdiagnose ulcerating or necrotic wounds from many other sources such as insects, infections or physical trauma as the bites of Loxosceles species.
However, he says, these brown spiders (females bear a violin-shaped pattern on the cephalothorax) are generally unaggressive, biting only when handled, trapped or pinned in garments or linens. Bites of the Loxosceles species are a major cause of necrotic araenism, which is marked by a red, white and blue targetoid lesion that develops 24 to 48 hours post-bite, Dr. Trevino says. By 72 hours, it ulcerates in an eccentric pattern, followed by eschar formation and slow healing and scar formation over weeks to months.
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