title: [Total upper lip necrosis and loxoscelism caused by violin spider bite].
abstract: Arthropods and in particular spiders are a common embodiment of our fears, despite the fact that only a few species are dangerous to man. The authors present a case involving severe local and general reactions to a loxosceles (brown recluse spider) bite. They give an overview of the occurrence of loxosceles spiders, the signs and symptoms of envenomation and the therapeutic possibilities. The severe symptoms presenting following loxosceles envenomation is termed loxoscelism. Loxoscelism is characterised by local soft tissue necrosis of varying degree at the site of the sting, and rarely, life-threatening general reactions, such as haemolysis with ensuing anaemia, and renal failure. Therapeutic interventions following loxosceles bites range from dapsone treatment to hyperbaric oxygen therapy, but the most promising therapy is the use of the antiserum, commercially available in certain South-American countries where loxosceles bites are common. Treatment of soft tissue necrosis consists of necrectomy and surgical reconstruction following the resolution of the inflammatory symptoms.
authors.affiliation: Semmelweis Egyetem, Fogorvostudományi Kar, Arc-AlIcsont-Szájsebészeti es Fogászati Klinika, Budapest.
authors.forename: Sándor
authors.initials: S
authors.lastname: Bogdán
authors.forename: József
authors.initials: J
authors.lastname: Barabás
authors.forename: Gábor
authors.initials: G
authors.lastname: Zacher
authors.forename: Tamás
authors.initials: T
authors.lastname: Huszár
authors.forename: Norbert
authors.initials: N
authors.lastname: Velich
authors.forename: György
authors.initials: G
authors.lastname: Szabó
authors.forename: Zsolt
authors.initials: Z
authors.lastname: Németh
mesh_terms: D000368:Aged; D005734:Gangrene / Q000209:etiology; D006801:Humans; D008046:Lip / Q000293:injuries* / Q000473:pathology* / Q000601:surgery; D008297:Male; D009336:Necrosis / Q000209:etiology; D010727:Phosphoric Diester Hydrolases / Q000633:toxicity*; D001098:Spider Bites / Q000188:drug therapy / Q000473:pathology* / Q000601:surgery / Q000628:therapy*; D013111:Spider Venoms / Q000633:toxicity*
chemical_list: D013111:Spider Venoms; C055161:loxosceles venom; D010727:Phosphoric Diester Hydrolases