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Swimmer's Itch
Aka: Swimmer's Itch, Cercarial Dermatitis
- Pathophysiology
- Predominately fresh water exposure
- Distribution
- Northern United States
- Canada
- Episodic outbreaks related to snail maturation
- Bright, warm days of summer induce snail shedding
- Most outbreaks occur near shore
- Inflammatory reaction to parasitic cercariae (larvae)
- Carriers: Snails
- Organisms
- Non-human schistosomes (parasitic flatworm)
- Flukes
- Mechanism
- Larvae penetrate Epidermis with water evaporation
- Larvae die once embedded
- Inflammatory reaction depends on sensitization
- Symptoms and symptoms
- Areas affected limited to exposed areas
- Initial Pruritus from Acute Urticarial reaction
- Pruritus within 1 hour (minimal to intense)
- Later papular eruption occurs
- First Exposure
- Papules within 5 to 13 days
- Subsequent Exposure (Sensitized)
- Pruritic Papules within hours
- Symptoms peak within 2-3 days
- Resolution within 7 days
- Differential Diagnosis
- Seabather's Eruption (limited to bathing suit area)
- Aquagenic Pruritus
- Management: Symptomatic for Pruritus
- Antihistamines
- Cool compresses
- Sarna or Calamine lotion
- Low to medium potency Topical Corticosteroids
- Complications
- Secondary infection related to excoriation
- Prevention
- Dry Skin immediately after bathing
- Course
- Lesions clear completely in 1 to 2 weeks
- References
- Habif (1996) Clinical Dermatology, 3rd ed, Mosby, 486
- Mulvihill (1990) Cutis 46:211-3 [PubMed]
- Pharis (1997) J Am Acad Dermatol 36:448-59 [PubMed]