[Cutaneous necrotic loxoscelism. A case report]

Area of Science:

• Toxicology
• Arachnology
• Dermatology

Background:

• Brown recluse spiders (Loxosceles spp.) are known to cause necrotic arachnidism, termed loxoscelism.
• The pathophysiology of Loxosceles venom-induced necrosis is complex and not fully elucidated.
• Sphingomyelinase D (SMD) is considered the primary enzyme responsible for necrotic lesion development.

Observation:

• A case report of a young adult male bitten by a brown recluse spider on the forearm.
• The initial bite resulted in a necrotic lesion that healed completely.
• One week later, two similar necrotic lesions appeared on the patient's left leg.

Findings:

• Diagnosis of loxoscelism was confirmed through clinical presentation and biopsy.
• The patient experienced delayed and recurring necrotic lesions.
• No systemic complications were observed in the patient.

Implications:

• This case highlights the potential for delayed and recurrent necrotic skin manifestations following Loxosceles envenomation.
• Further research is needed to fully understand the complex mechanisms of Loxosceles venom.
• Understanding these mechanisms can improve the diagnosis and management of necrotic arachnidism.