Cutaneous Loxoscelism On 5 Moroccan Cases

Abstract

Introduction: Loxoscelism is an under-diagnosed condition due to lack of awareness among practitioners. It is a serious form of araneism that can be strictly cutaneous with variable clinical aspects that can be deadly. Materials and methods: Five cases were collected over a period of 3 years presenting with envenomation by a supposed spider bite highly suggestive of cutaneous loxoscelism. Results: We collected five cases of post-spider bite envenomation with an average age of 45 years, predominantly female, of rural origin. The bite occurred in the summer in all cases. The average time to consultation was 2 days. Four patients had felt and located the spider nearby. Two patients had an erysipéloïde placard centred by a necrotic ulceration, while one had post-bite erythema multiforme, one had acute exanthematous pustulosis and one had acute urticaria. Biological tests were normal in all cases. Antihistamines and dermocorticoids were prescribed. Discussion: This type of envenomation is common in the summer months and in rural areas, with a clear female predominance. It is generally induced by the venom of spiders of the sicariidae family and of the Loxosceles genus. The diagnosis is based on a combination of epidemiological, clinical and biological evidence. Conclusion: Envenomation by spider bites has been little reported in Morocco until now. This rare cause of necrosis, skin rash deserves to be known by practitioners for an adequate management.