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Jellyfish Envenomation Presenting with Delayed Identical Cutaneous Lesions in a Mother and Child.

Chakrabarti A, Sengupta S - Indian J Dermatol (2015 Sep-Oct)

Bottom Line: This is a report of a mother and child who developed identical papular lesions in a bizarre, linear distribution after coming in contact with jellyfish almost simultaneously while on holiday.Histology showed focal basal cell degeneration along with peri-vascular and peri-appendageal lympho-mononuclear infiltrate.Both patients responded well to topical tacrolimus.

View Article: PubMed Central - PubMed

Affiliation: Department of Dermatology, KPC Medical College and Hospital, 1F, Raja SC Mullick Road, Kolkata, West Bengal, India.

ABSTRACT
Jellyfish envenomation can present with local cutaneous lesions both immediate and delayed. While the immediate reaction is toxin mediated, an immune mechanism is responsible for the delayed eruptions. This is a report of a mother and child who developed identical papular lesions in a bizarre, linear distribution after coming in contact with jellyfish almost simultaneously while on holiday. Histology showed focal basal cell degeneration along with peri-vascular and peri-appendageal lympho-mononuclear infiltrate. Both patients responded well to topical tacrolimus.

No MeSH data available.


Related in: MedlinePlus

Similar linear skin lesions in the mother
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Figure 2: Similar linear skin lesions in the mother

Mentions: A 35-year-old lady and her son aged 9 years presented with itchy, red, bizarre linear lesions on the arms. Two weeks ago, while on holiday in the Bintan island of Indonesia, first the son and then the mother who were swimming closely, came in contact with unidentified jellyfish within minutes of each other. They described severe burning pain and immediate development of burn like lesions at the site of contact. The locals present on the beach, applied vinegar to the lesions and removed the thread-like jellyfish body parts. A local physician prescribed pain killers, antihistamine and topical ointments. Neither developed any systemic symptoms. A week later both patients noted that the skin lesions were palpable with peeling of skin and severe itching. Clinical examination showed mildly erythematous papules with superficial scaling, coalescing to form linear lesions arranged in a crisscross configuration, extensively involving the right forearm of the boy [Figure 1]. The mother had similar lesions but less extensive on the left forearm [Figure 2]. Histopathological examination of a biopsy done on the mother showed focal basal cell degeneration with upper dermal lympho-mononuclear infiltrate. In addition there was peri-vascular and peri-appendageal lympho-mononuclear infiltrate. Eosinophils, neutrophils or any foreign body parts were not seen [Figure 3]. Both patients responded well to topical tacrolimus 0.1% ointment, topical emollients and oral antihistamine. A review at 4 months showed post-inflammatory hyperpigmentation.


Jellyfish Envenomation Presenting with Delayed Identical Cutaneous Lesions in a Mother and Child.

Chakrabarti A, Sengupta S - Indian J Dermatol (2015 Sep-Oct)

Similar linear skin lesions in the mother
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4601418&req=5

Figure 2: Similar linear skin lesions in the mother
Mentions: A 35-year-old lady and her son aged 9 years presented with itchy, red, bizarre linear lesions on the arms. Two weeks ago, while on holiday in the Bintan island of Indonesia, first the son and then the mother who were swimming closely, came in contact with unidentified jellyfish within minutes of each other. They described severe burning pain and immediate development of burn like lesions at the site of contact. The locals present on the beach, applied vinegar to the lesions and removed the thread-like jellyfish body parts. A local physician prescribed pain killers, antihistamine and topical ointments. Neither developed any systemic symptoms. A week later both patients noted that the skin lesions were palpable with peeling of skin and severe itching. Clinical examination showed mildly erythematous papules with superficial scaling, coalescing to form linear lesions arranged in a crisscross configuration, extensively involving the right forearm of the boy [Figure 1]. The mother had similar lesions but less extensive on the left forearm [Figure 2]. Histopathological examination of a biopsy done on the mother showed focal basal cell degeneration with upper dermal lympho-mononuclear infiltrate. In addition there was peri-vascular and peri-appendageal lympho-mononuclear infiltrate. Eosinophils, neutrophils or any foreign body parts were not seen [Figure 3]. Both patients responded well to topical tacrolimus 0.1% ointment, topical emollients and oral antihistamine. A review at 4 months showed post-inflammatory hyperpigmentation.

Bottom Line: This is a report of a mother and child who developed identical papular lesions in a bizarre, linear distribution after coming in contact with jellyfish almost simultaneously while on holiday.Histology showed focal basal cell degeneration along with peri-vascular and peri-appendageal lympho-mononuclear infiltrate.Both patients responded well to topical tacrolimus.

View Article: PubMed Central - PubMed

Affiliation: Department of Dermatology, KPC Medical College and Hospital, 1F, Raja SC Mullick Road, Kolkata, West Bengal, India.

ABSTRACT
Jellyfish envenomation can present with local cutaneous lesions both immediate and delayed. While the immediate reaction is toxin mediated, an immune mechanism is responsible for the delayed eruptions. This is a report of a mother and child who developed identical papular lesions in a bizarre, linear distribution after coming in contact with jellyfish almost simultaneously while on holiday. Histology showed focal basal cell degeneration along with peri-vascular and peri-appendageal lympho-mononuclear infiltrate. Both patients responded well to topical tacrolimus.

No MeSH data available.


Related in: MedlinePlus