title: [Cutaneous and visceral loxoscelism: a systematic review].
abstract: 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.
authors.affiliation: Departamento de Dermatología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile. jjmanriq@uc.cl
authors.forename: Juan J
authors.initials: JJ
authors.lastname: Manríquez
authors.forename: Sergio
authors.initials: S
authors.lastname: Silva
mesh_terms: 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