Senthilkumaran Subramanian, Almeida José R, Williams Jarred, Williams Harry F, Thirumalaikolundusubramanian Ponniah, Vaiyapuri Sakthivel
Manian Medical Centre, Erode, Tamil Nadu, India.
School of Pharmacy, University of Reading, Reading, UK.
Clin Toxicol (Phila). 2025 Feb;63(2):142-144. doi: 10.1080/15563650.2024.2432407. Epub 2024 Dec 3.
Snakebite envenoming is a multidimensional issue that causes severe functional and life-challenging consequences among rural communities in tropical countries. Current research and treatments are largely focused on the acute effects of envenomation and short-term health outcomes. The knowledge of snakebite-induced long-term consequences is highly limited.
We report the development of squamous cell carcinoma at the bite site several years later in four patients who are suspected to have been bitten by cobras (). Following bites, the victims presented typical symptoms of cobra envenomings including ptosis, altered sensorium, and breathing difficulties. However, difficult-to-heal wounds were a chronic health sequelae with frequent desquamation cycles which led to squamous cell carcinoma. Surgery as the primary therapeutic approach was used for all patients to address this issue.
These patients highlight the importance of squamous cell carcinoma in previously damaged tissue from snakebites as a possible long-term consequence. This emphasises the need for surveillance systems focused on a broad range of snakebite-induced consequences including long-term pathological, psychological, and socioeconomic conditions.
This case series describes pathological complications following cobra bites that require further research to determine mechanistic and epidemiological insights in the most affected regions by snakebites, specifically in India.
蛇咬伤中毒是一个多层面的问题,在热带国家的农村社区会导致严重的功能障碍和危及生命的后果。目前的研究和治疗主要集中在中毒的急性影响和短期健康结果上。关于蛇咬伤引起的长期后果的了解非常有限。
我们报告了4名疑似被眼镜蛇咬伤的患者在数年后咬伤部位发生鳞状细胞癌的情况()。咬伤后,受害者出现了眼镜蛇中毒的典型症状,包括上睑下垂、意识改变和呼吸困难。然而,难愈合的伤口是一种慢性健康后遗症,伴有频繁的脱屑周期,进而导致鳞状细胞癌。所有患者均采用手术作为主要治疗方法来解决这一问题。
这些患者凸显了蛇咬伤所致先前受损组织中鳞状细胞癌作为一种可能的长期后果的重要性。这强调了需要建立监测系统,关注包括长期病理、心理和社会经济状况在内的广泛的蛇咬伤所致后果。
本病例系列描述了眼镜蛇咬伤后的病理并发症,需要进一步研究以确定在蛇咬伤影响最严重的地区,特别是印度,其发病机制和流行病学情况。