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.
Physical Examination
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:
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Nausea
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Headache
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Sore throat
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Cough
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Diarrhea
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Abdominal pain
Two cases have been reported in which seabather's eruption presented as erythematous papules arranged in short linear paths, mimicking jellyfish envenomation from Olindias sambaquiensis and Chrysaora lactea, and resembling in appearance the Koebner phenomenon observed due to scratching of keratosis pilaris, but occurring shortly after sea bathing and not triggered by scratching. [9, 10]
Complications
Because of the nature of the allergic hypersensitivity underlying the disease, patients are susceptible to recurrence upon reexposure. Reports have described exaggerated symptomatology in recurrent cases of seabather's eruption, and, for such individuals, avoiding seawater on affected beaches during seasonal peaks is best.
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Seabather’s eruption. Courtesy of DermNet New Zealand (http://www.dermnetnz.org/assets/Uploads/arthropods/sea-bathers.jpg).
