Images in Dermatology
Viscerocutaneous Loxoscelism
Loxoscelismo cutáneo-visceral
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Cullen, P. Hasbún, M.P. Piquer" "autores" => array:3 [ 0 => array:4 [ "nombre" => "R." "apellidos" => "Cullen" "email" => array:1 [ 0 => "robertocullen@gmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0010" ] ] ] 1 => array:3 [ "nombre" => "P." "apellidos" => "Hasbún" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "M.P." "apellidos" => "Piquer" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "Departamento de Dermatología, Facultad de Medicina, Universidad de Chile, Santiago, Chile" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Centro de Especialidades Primarias San Lázaro, Santiago, Chile" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Facultad de Medicina Universidad de los Andes, Santiago, Chile" "etiqueta" => "c" "identificador" => "aff0015" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0010" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Loxoscelismo cutáneo-visceral" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:6 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1179 "Ancho" => 1667 "Tamanyo" => 205199 ] ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">We report the case of a 27-year-old woman who experienced intense pain in the left scapular region while sleeping. The pain was associated with 2 bleeding stitches, which progressed with local edema and erythema. On the third day, she went to the emergency department, since she had dark urine and the skin lesion had progressed to a violaceous plaque. The laboratory workup revealed anemia and involvement of renal function. She was admitted with a diagnosis of viscerocutaneous loxoscelism and received support therapy, chlorphenamine, cloxacillin, paracetamol, and hydrocortisone. Her condition progressed favorably, and she was discharged after 2 weeks. Local wound care was then applied, and she required an autologous skin graft for closure.</p><p id="par0010" class="elsevierStylePara elsevierViewall">Loxoscelism is a clinical syndrome caused by the bite of spiders of the genus <span class="elsevierStyleItalic">Loxosceles</span>. The syndrome has 2 subtypes: cutaneous loxoscelism, which starts with local erythema and pain that typically progresses to a necrotic ulcer varying in both extension and depth; and viscerocutaneous or systemic loxoscelism, which, in addition to the skin manifestations, is characterized by hemolytic anemia with renal involvement in severe cases. Cutaneous necrosis usually appears sometime around the third day and takes the form of a violaceous livedoid plaque. A dry, necrotic crust with very well-defined borders is visible at 1 week (<a class="elsevierStyleCrossRef" href="#fig0005">Figs. 1</a> a and b). The plaque detaches at 3-5 weeks. One of the keys to diagnosis is the appearance of the marks left on the skin by the spider's chelicerae (fangs) (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a> c).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Cullen R, Hasbún P, Piquer MP. Loxoscelismo cutáneo-visceral. Actas Dermosifiliogr. 2018;109:179.</p>" ] ] "multimedia" => array:1 [ 0 => array:6 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1179 "Ancho" => 1667 "Tamanyo" => 205199 ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/15782190/0000010900000002/v1_201803020443/S1578219017304304/v1_201803020443/en/main.assets" "Apartado" => array:4 [ "identificador" => "41141" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Images in Dermatology" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/15782190/0000010900000002/v1_201803020443/S1578219017304304/v1_201803020443/en/main.pdf?idApp=UINPBA000044&text.app=https://actasdermo.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219017304304?idApp=UINPBA000044" ]
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