An Elderly Diabetic Patient with Necrotic Arachnidism

Elghblawi Ebtisam, MBBCh, MSc, PG Dip


Dermatology Nursing. 2010;22(3):39-42. 

In This Article


The brown recluse spider is proficient at inflicting painful and necrotic wounds. The skin necrosis sometimes can be significant, and require a skin grafting or amputation of the affected skin to speed up healing (Forks, 2000; Peterson, 2006).

Necrotic arachnidism is a common health problem in Libya. This could be accredited to the year-round warm climate. It is especially common in the summer and in rural areas. However, there is no report in the literature about the spider species population in Libya as classification and recognition of the spider's population requires an arachnologist (Forks, 2000).

Moreover the reaction is unique for each affected person, and therefore management would imply tailoring it to each case accordingly (Leach, Bassichis, & Itani, 2004; Wasserman & Anderson, 1983–1984). A recent discovery stated that administration of tetracycline would inhibit the further skin necrosis progression caused by the spider bite venom, and based on this concept topical tetracycline could become a safe and efficacious means of therapy for the cutaneous loxoscelism in the future (King, 2007; Paixão-Cavalcante et al., 2007; Sams & King, 1999).

Current concepts regarding brown recluse spider envenomation are based on assumption as well as supposition because of poor case definition and scarcity of clinical evidence (Isbister & White, 2004; Mold & Thompson, 2004). There is no laboratory test to confirm the diagnosis, which remains based on history and typical presentation. Attempts are ongoing to construct a strategy for a definitive diagnosis of the brown recluse spider bite, but none is yet available (Wilson, Hagood, & Prather, 2005).


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