Exogenous pigmentation in toes feigning ischemia of the extremities: a diagnostic challenge brought by arthropods of the Diplopoda Class ("millipedes").
A 24 year-old patient reported having stepped on a millipede. When examined the patient presented cyanotic and erythematous macules on the first three toes of his right foot, and also complained of local pain and paresthesia, with palpable arterial flows. Millipedes are cylindrical segmented arthropods that when threatened form into curls and release quinones and other irritant and pigmentary substances. The cyanotic color reminds ischaemic tissular distress fact that may confuse professionals in Emergency Rooms when the clinical report is unclear.
Lima
Carlos Alberto Jatobá
CA
Fundação de Medicina Tropical do Amazonas, Manaus, AM, Brasil.
Cardoso
João Luiz Costa
JL
Magela
Antônio
A
Oliveira
Francisco G M de
FG
Talhari
Sinésio
S
Haddad Junior
Vidal
V
D000818:Animals; D001181:Arthropods; D001733:Bites and Stings / Q000150:complications* / Q000175:diagnosis*; D003937:Diagnosis, Differential; D006801:Humans; D017495:Hyperpigmentation / Q000175:diagnosis* / Q000209:etiology*; D007511:Ischemia / Q000175:diagnosis*; D008297:Male; D014034:Toes / Q000098:blood supply*; D055815:Young Adult