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Seabather's Eruption
Aka: Seabather's Eruption, Sea Lice
- Pathophysiology
- Salt water exposure
- Distribution
- Mexico
- Bermuda and Caribbean
- Eastern United States Coastline
- Florida
- Gulf States
- Long Island, New York
- Episodic outbreaks related to ocean currents
- Current carries Cnidaria larvae near shore
- Toxin injected by nematocyst
- Organism: Cnidaria larvae carry >200 nematocysts each
- Jellyfish larvae (e.g. Sea thimble)
- Man-of-war larvae
- Anemone larvae
- Fire Coral larvae
- Mechanism
- Larvae trapped within bathing suit (e.g. waistband)
- Larvae nematocysts are activated
- Skin contact
- Pressure
- Fresh water exposure
- Nematocyst forcefully injects toxin into skin
- Symptoms and Signs
- Initial
- Stinging Sensation on leaving water
- Minutes to hours (within 24 hours)
- Insect bit-like red pruritic Papules or wheals
- Papules (may coalesce)
- Constitutional Symptoms in severe cases
- Headache
- Fever
- Chills
- Provocative factors
- Prolonged wearing of contaminated swim suit
- Re-exposure can occur with contaminated suit
- Strenuous Exercise
- Fresh water exposure activates nematocysts
- Management
- Symptomatic for Pruritus
- Antihistamines
- Cool compresses
- Sarna or Calamine lotion
- Low to medium potency Topical Corticosteroids
- Severe cases
- Systemic Corticosteroids (i.e. Prednisone)
- Thiabendazole 1.5 grams bid for 2 days (adults)
- Course
- Rash persists 3 to 7 days (6 weeks in severe cases)
- Differential Diagnosis
- Swimmer's Itch (Fresh water to exposed areas)
- Prevention
- Avoid recently affected beach areas
- Public health officials should be notified
- Clean swim suits and wet suits thoroughly
- Shower immediately after swimming
- References
- Habif (1996) Clinical Dermatology, 3rd ed, Mosby, 486-7
- Basler (2000) J Am Acad Dermatol 43(2):299-305 [PubMed]
- Freudenthal (1993) N Engl J Med 329:542-4 [PubMed]
- Pharis (1997) J Am Acad Dermatol 36:448-59 [PubMed]
- Tomchik (1993) JAMA 269:1669-72 [PubMed]