Cutaneous Manifestations Following Exposures to Marine Life Workup

  • Author: Zoltan Trizna, MD, PhD; Chief Editor: William D James, MD   more...
 
Updated: Jan 3, 2012
 

Laboratory Studies

The following laboratory tests may be helpful:

  • Culture and sensitivity of infected wounds: Consider cultures for atypical Mycobacteria (M marinum) in the presence of granulomatous and ulcerating lesions or sporotrichoid spread. Other test results usually are noncontributory, unless systemic reactions are noted.
  • Intracutaneous tests with species-specific extracts: These can detect immediate and delayed-type reactions.
  • Serologic tests: These may reveal elevated immunoglobulins directed against specific antigens in patients with delayed cutaneous manifestations.
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Imaging Studies

Radiography is indicated to detect foreign body or involvement of deeper structures (eg, joint, bone).

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Procedures

Consider taking a biopsy when diagnosis is in doubt or when tissue culture is indicated.

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Histologic Findings

Histologic findings generally are nonspecific.

In seabather's eruption, superficial and deep perivascular and interstitial infiltrate consisting of lymphocytes, neutrophils, and eosinophils are described.

Biopsy of tissues infected with M marinum shows a mixed suppurative and granulomatous reaction with sparse-to-absent acid-fast bacilli.

Delayed skin reaction can be characterized by liquefaction degeneration of the basal layer.

Polarized light can reveal symmetric structures, corresponding to cross-sections of sea urchin spines.

Infections with V vulnificus show a nonspecific, yet characteristic, picture. Destruction extends into the dermis without an inflammatory cell infiltrate. Vasculitis may be present. Subepidermal noninflammatory bullae can be noted. Multiple organisms are observed.

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Contributor Information and Disclosures
Author

Zoltan Trizna, MD, PhD  Private Practice

Zoltan Trizna, MD, PhD is a member of the following medical societies: American Academy of Dermatology and Texas Medical Association

Disclosure: Nothing to disclose.

Specialty Editor Board

James J Nordlund, MD  Professor Emeritus, Department of Dermatology, University of Cincinnati College of Medicine

James J Nordlund, MD is a member of the following medical societies: American Academy of Dermatology, Sigma Xi, and Society for Investigative Dermatology

Disclosure: Nothing to disclose.

Michael J Wells, MD  Associate Professor, Department of Dermatology, Texas Tech University Health Sciences Center, Paul L Foster School of Medicine

Michael J Wells, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, and Texas Medical Association

Disclosure: Nothing to disclose.

Jeffrey Meffert, MD  Assistant Clinical Professor of Dermatology, University of Texas School of Medicine at San Antonio

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

Disclosure: Nothing to disclose.

Catherine M Quirk, MD  Clinical Assistant Professor, Department of Dermatology, University of Pennsylvania

Catherine M Quirk, MD is a member of the following medical societies: Alpha Omega Alpha and American Academy of Dermatology

Disclosure: Nothing to disclose.

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

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Mycobacterium marinum infection. Courtesy of the Department of Dermatology, UTMB at Galveston, Texas.
Jellyfish stings. Courtesy of the Department of Dermatology, UTMB at Galveston, Texas.
Erysipeloid. Courtesy of the Department of Dermatology, UTMB at Galveston, Texas.
Envenomation caused by Portuguese-man-of-war. Courtesy of the Department of Dermatology, UTMB at Galveston, Texas.
 
 
 
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