SUMMARYInjuries caused by venomous and poisonous aquatic animals may provoke important morbidity in humans. The phylum Echinoderma include more than 6000 species of starfish, sea urchins, sand dollars, and sea cucumbers some of which have been found responsible for injuries to humans. Initial injuries by sea urchins are associated with trauma and envenomation, but later effects can be observed. Sea urchin granuloma is a chronic granulomatous skin disease caused by frequent and successive penetration of sea urchin spines which have not been removed from wounds. The authors report a typical case of sea urchin granuloma in a fisherman and its therapeutic implications.

sUMMARYSeabather´s eruption (SBE) is an intensely itchy, papule-erythematous dermatitis that occurs predominantly in regions of the body covered by bathing costumes, after exposure to marine water. The planulae larvae of Linuche unguiculata scyphomedusae (thimble jellyfish) are the etiologic agent of the dermatitis, which is frequent in waters of Caribbean, Gulf of Mexico and Florida. The authors report 38 cases of SBE in the State of Santa Catarina (Southern region of Brazil), with emphasis on their clinical and epidemiological aspects, such as profile of victim, topography of the papules and conditions predisposing to the accident.

BackgroundAlthough known to be highly endemic in the Amazon regions of Brazil, the presence of cutaneous leishmaniasis (CL) in the subtropical southern part of the country has largely been ignored. This study was conducted to demonstrate CL is emerging in the Brazilian state of Santa Catarina, as well as to characterize the epidemiological profile and Leishmania species involved.Methodology/Principal FindingsFor this cross-sectional study, data from all CL cases from Santa Catarina, Brazil, reported to the Brazilian National Notifiable Diseases Information System from 2001 to 2009 were investigated. Amplification of the kDNA minicircle conserved region followed by restriction fragment length polymorphism (PCR-RFLP) was conducted to screen for Leishmania species present in patient biopsy. Overall, 542 CL cases were reported, with majority resulting from autochthonous transmission (n = 401, 73.99%) and occurring in urban zones (n = 422, 77.86%). Age, gender, zone of residence, origin of case, clinical form and case outcome were found to differ significantly by region. Imported cases were over seven times more likely to relapse (95% CI 2.56–21.09). Mapping of cases revealed new endemic areas in northeastern Santa Catarina with two species present. With the exception of three L. (Leishmania) amazonensis cases (1.20%), majority of PCR positive samples were found to be L. (Viannia) braziliensis (n = 248, 98.80%).Conclusions/SignificanceCL is now endemic in the state of Santa Catarina, Brazil, with case profiles varying significantly by region. L. (V.) braziliensis has been identified as the predominant species in the region.

Abstract:The authors report a case (in Itajai, Santa Catarina State, Brazil) of tinea nigra in a 4-year-old female child which spontaneously healed. We discuss the clinical and epidemiological aspects of the mycosis and this rare case of spontaneous healing.

RESUMO

SUMMARYThe authors report a case of bilateral Tinea nigra plantaris treated through a double-blind study with the topical antifungal agents Isoconazole and Terbinafine. The objective of the study was to clinically compare the efficacy of these two topical antifungal agents on days 10, 20 and 30 of the treatment. No significant clinical differences were found, as all the plantar lesions regressed completely by the end of the treatment. Our conclusion was that in the case reported, the topical antifungal agents Isoconazole and Terbinafine demonstrated identical efficacy as a clinical cure. We also suggest the inclusion of injuries caused by arthropods of the Diplopoda Class in the differential diagnosis of Tinea nigra plantaris, due to the persistent acral hyperpigmentation.

Seabather's eruption is characterized by the occurrence of intensely itchy erythematous papules observed mainly in the region covered by swimwear. The dermatitis occurs due to the contact of planula larvae of scyphomedusae Linuche unguiculata with the skin. The swimsuit pressure triggers the action of the poisonous stinging structures carried by the larvae. The case described occurred in a child who, while bathing in the ocean waters of the Northeast coast of Bessa's Beach located in the city of Joao Pessoa, state of Paraiba, showed typical clinical signs of the disease. It was concluded that the report of the case showed clinical and therapeutic implications for doctors working in all of the Brazilian coastal areas. Keywords: Brazil; Cnidaria; Cnidarian venoms; Dermatitis Resumo: O prurido do traje de banho é uma erupção caracterizada por pápulas eritematosas, intensamente pruriginosas, localizadas principalmente sob os trajes dos banhistas de mar. A dermatite ocorre pelo contato com as larvas plânulas da cifomedusa Linuche unguiculata que disparam seus nematocistos na pele do acidentado a partir das suas células de defesa, os cnidócitos. O caso ocorreu em uma criança que ao se banhar nas águas oceânicas do litoral da Região Nordeste na Praia do Bessa localizada na cidade de João Pessoa, Estado da Paraíba, apresentou quadro clínico típico da enfermidade. Concluiu-se que o relato do caso evidenciou implicações clínicas e terapêuticas para os médicos que atuam em todas as áreas litorâneas brasileiras.

Dear Editor:Seabather's eruption (SBE) is an acute dermatitis characterized by itchy and erythematous papules that appear during or after bathing in the sea. It is caused by contact with the larvae and adult of the jellyfish (Linuche unguiculata and L. aquila, recently found in the Philippines) and larvae of the sea anemone Edwardsiella lineata 1-3 . Limited information is available on this type of dermatitis. However, it is considered a public health concern in Brazilian coastal areas 2-7 . Here, we report two typical cases of SBE characterized by exuberant and eczematous lesions, aggravated by diagnostic confusion with dermatophytosis and parasitic infestations such as cutaneous larva migrans and scabies.Envenomations occurred in a female and male children aged 2 and 11 years, respectively, who frequently went to the coastal beaches in the state of Santa Catarina, Brazil. The children experienced a pricking sensation in the pubic, genital, and gluteal regions during sea bathing, which progressed to pruritus and intensified at night.The parents of the one child consulted a pharmacist, who diagnosed the condition as ringworm and recommended the use of topical ketoconazole. After 1 week of treatment, the manifestations had worsened. Thus, the parents sought consultation from a dermatologist. The other child was taken by his mother to a pediatric emergency department. The condition was diagnosed as cutaneous larva migrans, and topical thiabendazole was prescribed and used for 2 weeks. However, due to the aggravation of pruritus and lesions, the child returned to the hospital for consultation from the same pediatrician who changed the diagnosis to scabies. Topical permethrin was prescribed, but the mother subsequently decided to consult a dermatologist.Both dermatological examinations revealed intense pruritic and eczematous, erythematous papules located mainly in the gluteal regions (Figures 1A, B, E, and F). Dermoscopic examinations did not reveal the structures of L. unguiculata or cnidocytes, and examination of areas with exulcerated and meliceric crusting revealed nonspecific findings (Figures 1C, D, G, and H).The patients were treated with systemic antihistamines and corticosteroid creams. The condition of both the patients improved, with complete regression of the lesions and pruritus after 15 and 21 days of treatment, respectively.The occurrence of SBE among individuals living on the Brazilian coast is caused by the planulae and the scyphomedusa L. unguiculata, which is found on the Santa Catarina coast 2-8 . Limited information is available of this type of dermatitis, and its occurrence is mainly observed in individuals living on the coastlines of São Paulo and Santa Catarina 3-7 . In this study, the initial clinical manifestations, which include erythematous, itchy papules that appeared during exposure to seawater, particularly in areas covered by bathing suits, with a gradual increase in itching, were typical of SBE in children 1-7 .Clinical and epidemiological diagnoses can be made. However, the absence ...