• Omar Azuara-Antonio, Isidoro OrtizMarioM0000-0003-1047-6304MD, PhD. Professor, Department of Medicine, School of Health Sciences, Universidad Autónoma del Estado de Hidalgo. Pachuca, Hidalgo, Mexico., Karla Daniela Jiménez-Oliver, Marco Castillo-Cabrera, Ana Karen Méndez-Salinas, and Luz Hernández-Ramírez.
• MD. Physician, Medical staff, emergency department, general hospital de Pachuca. Pachuca, Hidalgo, Mexico; Subject teacher, Academic Field of Medicine, Institute of Health Sciences, Universidad Autónoma del Estado de Hidalgo, Pachuca, Hidalgo, Mexico.
• Sao Paulo Med J. 2024 Jan 1; 142 (4): e2023151e2023151.

BackgroundLoxosceles spp are arthropods found worldwide. Its bite may produce cutaneous loxoscelism (necrotic or edematous) or cutaneous-visceral loxoscelism. Depending on their severity and location, cutaneous forms are managed with local cold application and systemic administration of antihistamines, corticosteroids, antibiotics, polymorphonuclear inhibitors, and analgesics.ObjectiveThis study aimed to report a case of cutaneous loxoscelism and to identify the main dermatological manifestations associated with the Loxosceles spp bite.Design And SettingThis case report and literature review was conducted in a Mexican university.MethodsA detailed report on the medical management of a patient with cutaneous loxoscelism treated at the emergency department of a public hospital was published. Scopus, PubMed, Web of Science, and Google Scholar databases were searched to identify articles reporting cutaneous loxoscelism. The following keywords were used during the database search: "loxoscelism" OR "spider bite," OR "loxosceles" OR "loxosceles species" OR "loxosceles venom" OR "loxoscelism case report" AND "cutaneous" OR "dermonecrotic arachnidism."ResultsA 62-year-old female patient with cutaneous loxoscelism was treated with systemic dapsone and local heparin spray. Eighteen studies with 22 clinical cases were included in this systematic review. Of the 22 patients, 12 (54.5%) were men. L. rufescens was the predominant spider species.ConclusionsThe administration of dapsone and heparin for the management of cutaneous loxoscelism demonstrated success in this case, with no sequelae observed. In general, the literature review indicated favorable outcomes in patients treated with antimicrobials and corticosteroids, with continuous healing of skin lesions.Systematic Review RegistrationPROSPERO ID CRD42023422424 (https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023422424).

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