Department of Dermatology, Weill Cornell Medicine, New York, NY, USA.
Department of Dermatology, SUNY Downstate, Brooklyn, NY, USA.
J Dermatolog Treat. 2021 Mar;32(2):150-156. doi: 10.1080/09546634.2019.1638884. Epub 2019 Jul 11.
Sea urchin injuries (SUIs) are among the most common marine injuries; however, there are no guidelines to dictate appropriate workup and treatment. Complications vary significantly depending on the extent of injury, site of injury and elapsed time to medical attention. Timely and appropriate management can prevent long-term morbidity despite the deceptively innocuous appearance of these injuries. We review the English literature on SUIs and offer an algorithm to aid in the management of affected patients. We found that superficially retained spines may trigger a local granulomatous inflammatory response, while spines retained near deep structures may induce sea urchin arthritis, inflammatory tenosynovitis, among other delayed complications. Therefore, we recommend immediate inactivation of pro-inflammatory compounds by hot water soaks at the time of injury, followed by extraction of all spines by a physician. Imaging is a valuable component of risk stratification to determine depth and location of spines, which guides selection of appropriate extraction technique to prevent long-term morbidity.
海胆伤（SUIs）是最常见的海洋损伤之一；然而，目前尚无指导原则来规定适当的检查和治疗。并发症的严重程度差异很大，取决于损伤的程度、损伤部位和就医时间。尽管这些损伤看起来很轻微，但及时和适当的处理可以预防长期的发病率。我们回顾了关于 SUIs 的英文文献，并提供了一个算法来帮助管理受影响的患者。我们发现，表面残留的刺可能会引发局部肉芽肿性炎症反应，而残留于深部结构附近的刺可能会导致海胆关节炎、炎症性腱鞘炎等延迟性并发症。因此，我们建议在受伤时立即用热水浸泡来灭活促炎化合物，然后由医生提取所有的刺。影像学是进行风险分层的一个有价值的组成部分，以确定刺的深度和位置，这指导了选择适当的提取技术，以防止长期发病率。
