Seabather's Eruption Clinical Presentation

  • Author: Clarence William Brown Jr, MD; Chief Editor: William D James, MD   more...
 
Updated: Mar 28, 2012
 

History

The eruption begins a few hours after bathing in the ocean. Pruritus is the most common symptom in patients with seabather's eruption (98%). It typically lasts 1-2 weeks.

Fever and malaise are the next most commonly observed symptoms (23%). Fever is observed in 18% of patients. However, 40% of patients younger than 16 years report fever compared with 10% of adults. Systemic symptoms, including fever, nausea, abdominal pain, and diarrhea, are more common in children than in adults.

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Physical

On physical examination, patients with seabather's eruption typically display inflammatory papules in a distribution pattern that mimics the bathing suit. Lesions have been noted to occur in the axillae; in men with significant chest hair, they occur on the chest.

Relatively rare signs and symptoms of seabather's eruption include the following:

  • Nausea
  • Headache
  • Sore throat
  • Cough
  • Diarrhea
  • Abdominal pain
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Causes

Seabather's eruption is caused by exposure to the larval form (planulae) of the thimble jellyfish, L unguiculata. The seasonal variation in the concentrations of thimble jellyfish larvae in endemic areas lead to the increased incidence of seabather's eruption from May through August, with a peak in May and June.

Freudenthal and Joseph[3] reported the larvae of the sea anemone Edwardsiella lineata as the cause of an outbreak of seabather's eruption on Long Island, New York. This organism also has nematocysts. Various species of Cnidaria larvae in other waters can likely produce similar eruptions.

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Contributor Information and Disclosures
Author

Clarence William Brown Jr, MD  Assistant Professor of Dermatology, Dermatologic and Mohs Micrographic Surgery, Rush University Medical Center

Clarence William Brown Jr, MD, is a member of the following medical societies: American Academy of Dermatology, American College of Mohs Micrographic Surgery and Cutaneous Oncology, American Medical Association, Chicago Dermatological Society, Chicago Medical Society, Illinois Dermatological Society, and Illinois State Medical Society

Disclosure: Nothing to disclose.

Specialty Editor Board

Carrie L Kovarik, MD  Assistant Professor of Dermatology, Dermatopathology, and Infectious Diseases, University of Pennsylvania School of Medicine

Carrie L Kovarik, MD is a member of the following medical societies: Alpha Omega Alpha

Disclosure: Nothing to disclose.

Richard P Vinson, MD  Assistant Clinical Professor, Department of Dermatology, Texas Tech University Health Sciences Center, Paul L Foster School of Medicine; Consulting Staff, Mountain View Dermatology, PA

Richard P Vinson, MD is a member of the following medical societies: American Academy of Dermatology, Association of Military Dermatologists, Texas Dermatological Society, and Texas Medical Association

Disclosure: Nothing to disclose.

Jeffrey P Callen, MD  Professor of Medicine (Dermatology), Chief, Division of Dermatology, University of Louisville School of Medicine

Jeffrey P Callen, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American College of Physicians, and American College of Rheumatology

Disclosure: Amgen Honoraria Consulting; Celgene Honoraria Safety Monitoring Committee

Joel M Gelfand, MD, MSCE  Medical Director, Clinical Studies Unit, Assistant Professor, Department of Dermatology, Associate Scholar, Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania

Joel M Gelfand, MD, MSCE is a member of the following medical societies: Society for Investigative Dermatology

Disclosure: AMGEN Consulting fee Consulting; AMGEN Grant/research funds Investigator; Genentech Grant/research funds investigator; Centocor Consulting fee Consulting; Abbott Grant/research funds investigator; Abbott Consulting fee Consulting; Novartis investigator; Pfizer Grant/research funds investigator; Celgene Consulting fee DMC Chair; NIAMS and NHLBI Grant/research funds investigator

Chief Editor

William D James, MD  Paul R Gross Professor of Dermatology, Vice-Chairman, Residency Program Director, Department of Dermatology, University of Pennsylvania School of Medicine

William D James, MD is a member of the following medical societies: American Academy of Dermatology and Society for Investigative Dermatology

Disclosure: Elsevier Royalty Other

References

  1. Segura Puertas L, Burnett JW, Heimer de la Cotera E. The medusa stage of the coronate scyphomedusa Linuche unguiculata ('thimble jellyfish') can cause seabather's eruption. Dermatology. 1999;198(2):171-2. [Medline].

  2. Kumar S, Hlady WG, Malecki JM. Risk factors for seabather's eruption: a prospective cohort study. Public Health Rep. Jan-Feb 1997;112(1):59-62. [Medline].

  3. Freudenthal AR, Joseph PR. Seabather's eruption. N Engl J Med. Aug 19 1993;329(8):542-4. [Medline].

  4. Wong DE, Meinking TL, Rosen LB, Taplin D, Hogan DJ, Burnett JW. Seabather's eruption. Clinical, histologic, and immunologic features. J Am Acad Dermatol. Mar 1994;30(3):399-406. [Medline].

  5. Bernhardt MJ, Mandojana RM. "Seabather's eruption". Clin Dermatol. Jul-Sep 1987;5(3):101-2. [Medline].

  6. Burnett JW, Calton GJ, Burnett HW. Jellyfish envenomation syndromes. J Am Acad Dermatol. Jan 1986;14(1):100-6. [Medline].

  7. Fisher AA. Toxic and allergic cutaneous reactions to jellyfish with special reference to delayed reactions. Cutis. Oct 1987;40(4):303-5. [Medline].

  8. Kettle M. Americans adrift in an ocean of fears. The Guardian Weekly. February 8, 2001:Available at http://www.vuw.ac.nz/~caplabtb/dprk/adrift.html.

  9. Letot B, Kharfi M, Mandojana R, Piérard GE. [Undesirable reactions from contact with marine organisms]. Rev Med Liege. Jun 2000;55(6):531-7. [Medline].

  10. Mandojana RM, Letot B. Historical outlook of aquatic biotoxicology and balneology as related to dermatology. Classification of aquatic dermatoses. Clin Dermatol. Jul-Sep 1987;5(3):1-7. [Medline].

  11. Mandojana RM, Sims JK. Miscellaneous dermatoses associated with the aquatic environment. Clin Dermatol. Jul-Sep 1987;5(3):134-45. [Medline].

 
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