Recurrent Dermatitis and Dermal Hypersensitivity Following a Jellyfish Sting: A Case Report and Review of Literature

Authors

  • Manuela Loredana Asztalos M.D.,

    1. Department of Pediatrics, St. Christopher's Hospital, Philadelphia, Pennsylvania
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  • Adam I. Rubin M.D.,

    1. Section of Dermatopathology, Department of Dermatology, School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
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  • Rosalie Elenitsas M.D.,

    1. Section of Dermatopathology, Department of Dermatology, School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
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  • Caroline Groft MacFarlane M.D., Ph.D.,

    1. Dermatology Associates of Bryn Mawr Medical Specialists, Bryn Mawr, Pennsylvania
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  • Leslie Castelo-Soccio M.D., Ph.D.

    Corresponding author
    1. Pediatrics, Section of Pediatric Dermatology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
    • Address correspondence to Leslie Castelo-Soccio, M.D., Ph.D., Department of Pediatrics, Section of Pediatric Dermatology, Children's Hospital of Philadelphia, 3550 Market Street, 2nd Floor, Dermatology, Philadelphia, PA 19104, or e-mail: castelosocciol@email.chop.edu.

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Abstract

Jellyfish envenomation often causes an immediate painful vesiculopapular eruption. Less commonly it can cause a type IV allergic hypersensitivity that manifests with delayed or recurrent cutaneous lesions at the primary site or distant from the primary site. These secondary reactivations may be related to high antijellyfish immunoglobulin levels, intracutaneously sequestered antigen, or cross-reacting venom. Immunomodulators such as pimecrolimus and tacrolimus and topical and intralesional corticosteroid therapy decrease this recurrent dermatitis. We report a case of a 9-year-old girl with a recurrent jellyfish dermatitis lasting more than 1 year after the initial envenomation. The dermatitis finally resolved after treatment with tacrolimus and intralesional triamcinolone acetonide therapy.

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