[Necrotic arachnidism in the south of France: two clinical cases of loxoscelism].
BACKGROUND
loxosceles spiders are found throughout the world and are responsible for numerous cases of envenomation in America and Southern Europe. We describe, to our knowledge for the first time in France, two clinical cases of cutaneous loxoscelism.


METHODS
two cases of skin necrosis arising after supposed spider bites were grouped together because of their similar clinical presentation: an initial painless bite and rapid development of an inflammatory and painful cutaneous lesion with a central hemorrhagic bulla surrounded by a perimeter of blanched skin (the "red, white, and blue" sign). The outcome in both cases was deep skin necrosis and chronic ulceration requiring surgical treatment.


CONCLUSIONS
loxoscelism can result in dermonecrosis. Although our cases were not documented by capture of the spider, the diagnosis of cutaneous loxoscelism was supported by the characteristic appearance of the lesion, a typical clinical course, elimination of differential diagnoses, and the confirmed presence of Loxosceles rufescens in the region.


CONCLUSIONS
loxoscelism can occur in the south of France and although rare, must be considered in this region as a possible cause of skin necrosis.
Service de Dermatologie, Groupe Hospitalo-universitaire Carémeau, Place du Pr-R.-Debré, 30029 Nîmes, France.
C
C
Pernet
M
M
Dandurand
L
L
Meunier
P-E
PE
Stoebner
D000328:Adult; D000818:Animals; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010727:Phosphoric Diester Hydrolases / Q000633:toxicity*; D001098:Spider Bites / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D013111:Spider Venoms / Q000633:toxicity*; D013112:Spiders / Q000145:classification*; D013524:Surgical Flaps; D055815:Young Adult
D013111:Spider Venoms; C055161:loxosceles venom; D010727:Phosphoric Diester Hydrolases