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Upper eyelid necrosis and reconstruction after spider byte: case report and review of the literature.

Abstract

Spider bites are not very common, especially in the Mediterranean area, and those affecting the ocular-palpebral region involving reconstructive surgery are particularly rare. In May 2010, the case of a Caucasian 24-year-old female patient was brought to the attention of the Dermatology Department, University of Cagliari, Italy. The patient reported she woke up feeling an intense pain with itching and that also she had noticed a spider of an unknown species on her bed. The dermatosis had affected the right orbital region, where there was a considerable red and violet erythema and a hard edema, not foldable. When the necrosis appeared the patient was treated at the Plastic Surgery Unit where she underwent a reconstruction of the eyelid with a full thickness skin graft from the retroauricular area. The post-operative course was regular with a perfect in-take of the skin graft. When the patient was discharged she was sent to an Entomological University Centre to identify the spider species and the possible venom which caused the skin lesion. The spider which caused the injury has been a Loxosceles rufescens (Dufour, 1820). Loxoscelism is a necrotic arachnoidism caused by the poisonous bite of spiders belonging to the Loxosceles species. It is very important to identify what sort of lesion it is and to treat it in a combined way in order to choose the proper timing for surgery to avoid damages to the eyelid functioning.

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  • Authors

    Ribuffo D, Serratore F, Famiglietti M, Greco M, Fois F, Atzori L, Pau M, Aste N

    Source

    European review for medical and pharmacological sciences 16:3 2012 Mar pg 414-7

    MeSH

    Animals
    Anti-Bacterial Agents
    Eyelids
    Female
    Humans
    Necrosis
    Phosphoric Diester Hydrolases
    Reconstructive Surgical Procedures
    Spider Bites
    Spider Venoms
    Spiders
    Young Adult

    Pub Type(s)

    Case Reports
    Journal Article

    Language

    eng

    PubMed ID

    22530360