Necrotic loxoscelism in lower limb and reconstruction with skin autograft

Authors

  • Leonel Iturbide Mauricio Department of Surgery, Hospital Regional De Alta Especialidad De Ciudad Victoria, Ciudad Victoria, Tamaulipas, Mexico
  • Hugo E. Lopez-Herrera Department of Surgery, Hospital Regional De Alta Especialidad De Ciudad Victoria, Ciudad Victoria, Tamaulipas, Mexico
  • Josue I. Perez-Puertos Department of Surgery, Hospital Regional De Alta Especialidad De Ciudad Victoria, Ciudad Victoria, Tamaulipas, Mexico
  • Giovanni A. Rodriguez-Barrón Department of Surgery, Hospital Regional De Alta Especialidad De Ciudad Victoria, Ciudad Victoria, Tamaulipas, Mexico
  • Abigail Guerrero-Mercado Department of Surgery, Hospital Regional De Alta Especialidad De Ciudad Victoria, Ciudad Victoria, Tamaulipas, Mexico

DOI:

https://doi.org/10.18203/2320-6012.ijrms20241572

Keywords:

Spider bite, Loxoscelism, Vacuum therapy, Skin autograft, Reconstruction, Skin autografting

Abstract

Loxesceles are small spiders, from 9 to 25 mm, with a dark brown spot on the dorsal part in the shape of an inverted violin. They are common in northwestern Mexico and can live at temperatures of 8 to 40°C. These spiders are considered of medical importance because their venom is dermonecrotic, with proteolytic and necrotic action, which is generated in two apocrine glands. The cutaneous clinical picture is the most frequent, with edema, erythema and ischemia that tends to evolve to ulceration and deep necrosis. The key to treatment is early debridement to avoid complications. We presented the case of a 57-year-old female patient who developed an inflammatory condition secondary to a fiddler spider bite involving the left lower extremity. Her evolution to necrosis and late diagnosis required surgical debridement and use of negative pressure therapy (VAC), followed by harvesting and placement of partial thickness skin autograft, obtaining a successful aesthetic and functional result.

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References

Martínez-Ortiz D, Torres-Castro M, Arisqueta-Chablé C, Salceda-Sánchez B, Huerta H, Palacio-Vargas J, et al. First record of a case of cutaneous loxoscelism caused by violin spider (Loxosceles yucatana) bite in Yucatan, Mexico. Primer registro de un caso de loxoscelismo cutáneo ocasionado por mordedura de araña violinista (Loxosceles yucatana) en Yucatán, México. Rev Peru Med Exp Salud Publica. 2022;39(4):489-94.

Navarro-Rodríguez CI, Valdez-Mondragón A. Description of a new species of Loxosceles Heineken & Lowe (Araneae, Sicariidae) recluse spiders from Hidalgo, Mexico, under integrative taxonomy: morphological and DNA barcoding data (CO1 + ITS2). EJT. 2020:704:1-30.

Valdez-Mondragón A, Cortez-Roldán MR, Juárez-Sánchez AR, Solís-Catalán KP, Navarro-Rodríguez CI. Medically important spiders: fiddler spiders of the genus Loxosceles in Mexico, what do we know about their distribution and biology so far? AMXSA Bulletin. 2018;2(1):14-24.

Roodt AR, Salomón OD, Lloveras SC, Orduna TA. Poisoning by spiders of Loxosceles genus. Medicina (B Aires). 2002;62(1):83-94.

Morales-Avalos, Juliana M, Torres-Moreno, Adolfo J, Arce-Sanchez, Hiram J, et al. Necrotic palpebral loxoscelism and reconstruction with cutaneous autograft: a case report. Mexican J Ophthalmol. 2021;9(1):37-40.

Hernández Pérez N, Alonso-Gordo JM, Fuentes-López Á. Cutaneous Loxocelism. Rev Clin Med Fam. 2012;5(1):73-5.

Rodriguez R, Saavedra-Velasco M, Grandez-Urbina JA. A pathophysiological approach of liver loxoscelism. Rev Gastroenterol Peru. 2017;37(3):287-8.

Padilla F, Ramos H, Favela MR, Flores SA, Macías JE, Berrones‑Garza M, et al. Reconstruction of complex leg wound sequelae: 3-year experience. Cir Plast. 2019;29(3):248-54.

Silva BM, Yuste BV, Monclús F, Rodrigo PE, Gómez Escolar LL, González PE. Treatment of E. coli necrotizing fasciitis by surgical debridement and VAC therapy: a case report. Cir Plast Iberolatinoam. 2011;37(1):19-24.

Ratner D. Skin grafting. From here to there. Dermatol Clin. 1998;16(1):75-90.

Shimizu R, Kishi K. Skin graft. Plast Surg Int. 2012;2012:563493.

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Published

2024-05-31

How to Cite

Mauricio, L. I., Lopez-Herrera, H. E., Perez-Puertos, J. I., Rodriguez-Barrón, G. A., & Guerrero-Mercado, A. (2024). Necrotic loxoscelism in lower limb and reconstruction with skin autograft. International Journal of Research in Medical Sciences, 12(6), 2122–2125. https://doi.org/10.18203/2320-6012.ijrms20241572

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Section

Case Reports