Pernet C, Dandurand M, Meunier L, Stoebner P-E
Service de Dermatologie, Groupe Hospitalo-universitaire Carémeau, Place du Pr-R.-Debré, 30029 Nîmes, France.
Ann Dermatol Venereol. 2010 Dec;137(12):808-12. doi: 10.1016/j.annder.2010.08.008.
loxosceles spiders are found throughout the world and are responsible for numerous cases of envenomation in America and Southern Europe. We describe, to our knowledge for the first time in France, two clinical cases of cutaneous loxoscelism.
two cases of skin necrosis arising after supposed spider bites were grouped together because of their similar clinical presentation: an initial painless bite and rapid development of an inflammatory and painful cutaneous lesion with a central hemorrhagic bulla surrounded by a perimeter of blanched skin (the "red, white, and blue" sign). The outcome in both cases was deep skin necrosis and chronic ulceration requiring surgical treatment.
loxoscelism can result in dermonecrosis. Although our cases were not documented by capture of the spider, the diagnosis of cutaneous loxoscelism was supported by the characteristic appearance of the lesion, a typical clinical course, elimination of differential diagnoses, and the confirmed presence of Loxosceles rufescens in the region.
loxoscelism can occur in the south of France and although rare, must be considered in this region as a possible cause of skin necrosis.
巴西游走蛛遍布全球，在美国和南欧导致了大量中毒病例。据我们所知，我们首次在法国描述了两例皮肤型巴西游走蛛中毒的临床病例。
两例因疑似蜘蛛叮咬后出现皮肤坏死的病例被归为一组，因其临床表现相似：最初为无痛性叮咬，随后迅速发展为炎性疼痛性皮肤病变，中央有出血性大疱，周围是变白的皮肤（“红、白、蓝”体征）。两例的结局均为深部皮肤坏死和慢性溃疡，需要手术治疗。
巴西游走蛛中毒可导致皮肤坏死。虽然我们的病例没有通过捕获蜘蛛来记录，但皮肤型巴西游走蛛中毒的诊断得到了病变的特征性外观、典型的临床病程、排除鉴别诊断以及该地区确认存在棕巴西游走蛛的支持。
巴西游走蛛中毒可发生在法国南部，虽然罕见，但在该地区必须将其视为皮肤坏死的可能原因。
