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ABSTRACT
In this presentation, the most common aquatic skin reactions to biotoxins observable in the Mediterranean area are considered and, in particular, the various clinical pictures induced by Coelenterates (jelly fish and sea anemones), the reactions to sea urchins and various types of fish, the granulomas from Mycobacterium marinum, and the
dermatitis caused by some aquatic worms. Reactions to jelly fish stings present with various morphological pictures: the most common are localized urticarious reactions lasting between a few minutes and several hours according to the intensity of the damage. The reactions due to sea anemones generally present with much more marked
local and systemic symptoms than those from jelly fish. They are vesicular or blistering and sometimes necrotizing; the course of the complaint lasts from 15 to 20-30 days, with dyschromic or scarring sequelae. Sea urchins can cause an immediate and two different delayed reactions due to penetration in the skin of their spines. The most common delayed reaction (sea urchin granulomas) features hard, parenchymatous and brownish-red in colour lesions. The other type of delayed reaction (occupational chronic traumatic scleroedema) manifests with hard and persistent oedema of the backs of the hands and sometimes also of the forearms. It is caused by repeated
penetration of sea urchin spines, together with the constriction of the wrists caused by wetsuit. Sting-rays and weever-fish, which live on sandy bottoms half-hidden under the sand, sting man with their spines; the resulting systemic symptoms can be very severe and last 24-48 hours. Mycobacterium marinum, which can be found in both salt and fresh water, can induce granulomas after an incubation period of 2-3 weeks. Some Polychaetae annelid worms may induce in fishermen using lines a peculiar contact dermatitis of the hands, involving fingertips, proximal nail folds and nails. Fishermen with dermatitis from sponges notice an itching or stinging sensation, followed, within a few hours, by pain, oedema and rigidity of the hands, together with
erythema and blisters. Larva migrans cutanea, caused by various nematode larvae, manifests with linear lesions of a variable intense reddish colour. |
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