[Cutaneous and visceral loxoscelism: a systematic review].
BACKGROUND
Loxoscelism represents a major public health problem for which there are no standard therapeutic interventions.


OBJECTIVE
To review available scientific evidence on management of Loxoscelism


METHODS
Systematic review of clinical studies. The search included multiple databases (Medline, Lilacs, Embase, Web of Sciences, Cinahl, Pre-Cinahl, Paperfirst, Proceedingsfirst, Dissertations and Theses, Toxline, Cochrane Library), handsearch of references, and contact with experts.


RESULTS
Three clinical trials of poor methodological quality were identified from 5,207 references found. One trial (n = 31), concluded that the use of dapsone was associated with fewer local complications than surgical treatment. A second study (n = 46), concluded that the use of dapsone was superior to clorfenamine for skin lesions. A third study (n = 95) concluded that there was no differences between the use of oral dapsone, antivenom against anti-Loxosceles reclusa or a combination of both.


CONCLUSIONS
There is insufficient evidence based on good quality studies to recommend treatment guidelines for individuals with skin or visceral loxoscelism.
Manríquez
Juan J
JJ
Departamento de Dermatología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile. jjmanriq@uc.cl
Silva
Sergio
S
D002986:Clinical Trials as Topic; D019317:Evidence-Based Medicine; D006801:Humans; D012871:Skin Diseases / Q000209:etiology* / Q000628:therapy; D001098:Spider Bites / Q000150:complications* / Q000628:therapy