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Journal of the American Academy of Dermatology
Volume 61, n° 5
pages 733-750 (novembre 2009)
Doi : 10.1016/j.jaad.2009.01.046
Continuing Medical Education

Tropical dermatology: Marine and aquatic dermatology

Vidal Haddad, MD, PhD a, Omar Lupi, MD, PhD b, Juan Pedro Lonza, MD c, Stephen K. Tyring, MD, MBA, PhD d,
a Department of Dermatology at the Universidade Estadual Paulista (UNESP), Botucatu, Vital Brazil Hospital, Instituto Butantan and Marine School of Biology, São Paulo State, São Paulo, Brazil 
b Department of Dermatology, Dermatology Section - Universidade Federal do Estado do Rio de Janeiro (UniRio) and Policlinica Geral do Rio de Janeiro (PGRJ), Immunology Section - Faculdade de Medicina - Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil 
c private practice, Iquique, Chile 
d Departments of Dermatology, Microbiology and Molecular Genetics, and Internal Medicine, University of Texas Health Science Center, Houston, Texas 

Reprint requests: Stephen K. Tyring, MD, MBA, PhD, Clinical Professor of Dermatology, Microbiology & Molecular Genetics, and Internal Medicine, University of Texas Health Science Center, 6655 Travis, Ste 100, Houston, TX 77030.

Dermatoses caused by marine organisms are frequently seen in dermatology clinics worldwide. Cutaneous injuries after exposure to marine environments include bacterial and fungal infections and lesions caused by aquatic plants and protists. Some of these diseases are well known by dermatologists, such as Vibrio vulnificus septicemia and erysipeloid, but others are uncommon, such as envenomation caused by ingestion or contact with certain dinoflagellates or cyanobacteria, which are associated with rashes that can begin within minutes after exposure. Many marine/aquatic invertebrates, such as sponges, cnidarians, echinoderms, crustaceans, and mollusks, are associated with different kinds of dermatologic lesions that can vary from irritant or allergic contact dermatitis to physical trauma and envenomations. These cutaneous lesions may result in mild local reactions or can be associated with severe systemic reactions. Invertebrate animals, such as cnidarians, sea urchins, and worms, and aquatic vertebrates, such as venomous fishes and stingrays, are commonly associated with skin lesions in many countries, where they can constitute occupational dermatoses among fishermen and scuba divers, but they can also be observed among persons who contact these animals in kitchens or beaches. The presence of unusual lesions, a recent travel history, and/or a report of contact with an aquatic environment (including ownership of a marine or freshwater aquarium) should alert the dermatologist to the etiology of the cutaneous problems.

Learning objectives

After completing this learning activity, participants should be able to recognize the cutaneous manifestations of marine/aquatic infections, bites, stings, and wounds, etc., treat the cutaneous manifestations of marine/aquatic injuries, and help prevent marine/aquatic injuries.

The full text of this article is available in PDF format.

Key words : cnidarians, contact dermatitis, crustaceans, envenomation, fish, mollusks

 Funding sources: None.
 Conflicts of interest: The authors, editors, and peer reviewers have no relevant financial relationships.

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