# Utilization of dapsone and hemoglobin in the epithelial skin regeneration therapy of cutaneous loxoscelism: A case report and integrative literature review

## TL;DR

This paper reports a successful treatment of a spider bite using dapsone and heparin, and reviews existing literature on skin-related spider bite cases.

## Contribution

The novel contribution is the successful use of dapsone and heparin in treating cutaneous loxoscelism, supported by a case report and literature review.

## Key findings

- Systemic dapsone and local heparin spray effectively treated cutaneous loxoscelism in a 62-year-old female with no sequelae.
- A literature review of 22 cases showed favorable outcomes with antimicrobials and corticosteroids for skin lesion healing.
- Loxosceles rufescens was the most commonly reported spider species in the reviewed cases.

## Abstract

Loxosceles spp are arthropods found worldwide. Its bite may produce cutaneous loxoscelism (necrotic or edematous) or cutaneous-visceral loxoscelism. Depending on their severity and location, cutaneous forms are managed with local cold application and systemic administration of antihistamines, corticosteroids, antibiotics, polymorphonuclear inhibitors, and analgesics.

This study aimed to report a case of cutaneous loxoscelism and to identify the main dermatological manifestations associated with the Loxosceles spp bite.

This case report and literature review was conducted in a Mexican university.

A detailed report on the medical management of a patient with cutaneous loxoscelism treated at the emergency department of a public hospital was published. Scopus, PubMed, Web of Science, and Google Scholar databases were searched to identify articles reporting cutaneous loxoscelism. The following keywords were used during the database search: “loxoscelism” OR “spider bite,” OR “loxosceles” OR “loxosceles species” OR “loxosceles venom” OR “loxoscelism case report” AND “cutaneous” OR “dermonecrotic arachnidism.”

A 62-year-old female patient with cutaneous loxoscelism was treated with systemic dapsone and local heparin spray. Eighteen studies with 22 clinical cases were included in this systematic review. Of the 22 patients, 12 (54.5%) were men. L. rufescens was the predominant spider species.

The administration of dapsone and heparin for the management of cutaneous loxoscelism demonstrated success in this case, with no sequelae observed. In general, the literature review indicated favorable outcomes in patients treated with antimicrobials and corticosteroids, with continuous healing of skin lesions.

PROSPERO ID CRD42023422424 (https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023422424).