Ann Dermatol.  2008 Dec;20(4):212-215. 10.5021/ad.2008.20.4.212.

A Case of Cellulitis Associated with Coral Injury

• Na SY
• Lee HY
• Baek JO
• Roh JY
• Lee JR

• KMID: 2156397
• DOI: http://doi.org/10.5021/ad.2008.20.4.212

Abstract

Corals are the marine organism that belongs to the phylum Cnidaria, and are one of the common causes of superficial injury in the marine environment. In addition to acute reactions such as burning or stinging pain and erythema, coral injuries may present with complications such as foreign body reactions, bacterial infections, and/or localized eczematous reactions. A 23-year-old male presented with an erythematous edematous tender patch with centrally grouped vesicles on the left ankle; the injury had occurred during skin-scuba diving 2 days before. A biopsy of the lesion treated with hematoxylin-eosin stain showed epidermal necrosis with subepidermal blisters and neutrophilic panniculitis. Herein we report a case of cellulitis caused by the nematocyst stings of corals.

Keyword

Cellulitis; Coral

MeSH Terms

Anthozoa
Aquatic Organisms
Bacterial Infections
Biopsy
Bites and Stings
Blister
Burns
Cellulitis
Cnidaria
Diving
Erythema
Foreign Bodies
Humans
Male
Necrosis
Nematocyst
Neutrophils
Panniculitis
Young Adult

Figure

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  Fig. 1 Erythematous edematous patch with central grouped vesicles on the left ankle.

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  Fig. 2 (A) Histopathologic findings show extensive epidermal necrosis with subepidermal blisters (H&E, ×10). (B) There are some neutrophils within the blister cavity (H&E, ×20)

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  Fig. 3 Mild to moderate interstitial, perivascular, and periadnexal inflammatory cell infiltrate of neurophils in the dermis (H&E, ×10).

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  Fig. 4 Panniculitis mainly infiltrated with neutrophils, some eosinophils, and lymphohistiocytes (H&E, ×10).

Reference

1. Scharf MJ, Daly JS. Bites and stings of terrestrial and aquatic life. In : Freedberg IM, Eisen AZ, Wolff K, Austen KF, Goldsmith LA, Katz SI, editors. Fitzpatrick's dermatology in general medicine. 6th ed. New York: McGraw-Hill;2003. p. 2270–2271.

2. Burke WA. Cnidarians and human skin. Dermatol Ther. 2002; 15:18–25.

3. Zoltan TB, Taylor KS, Achar SA. Health issues for surfers. Am Fam Physician. 2005; 71:2313–2317.

4. Auerbach PS, Burgess GH. Injuries from nonvenomous aquatic animals. In : Auerbach PS, editor. Wilderness medicine [Internet]. 5th ed. Philadelphia: Mosby Elsevier;2007. cited 2008 May 2. Available from: http://www.mdconsult.com/das/book/body/93629417-2/0/1483/692.html?tocnode=54238530&fromURL=692.html#4-u1.0-B978-0-323-03228-5..50077-X--cesec56_4329.

5. Habif TP. Dermatitis associated with swimming. In : Habif TP, editor. Clinical dermatology: a color guide to diagnosis and therapy. 4th ed. Chile: Mosby;2004. p. 539–543.

6. Miracco C, Lalinga AV, Sbano P, Rubegni P, Romano C. Delayed skin reaction to Red Sea coral injury showing superficial granulomas and atypical CD30+ lymphocytes: report of a case. Br J Der matol. 2001; 145:849–851.

7. Addy JH. Red sea coral contact dermatitis. Int J Dermatol. 1991; 30:271–273.

8. Dagregorio G, Guillet G. Delayed dermal hypersensitivity reaction to coral. J Am Acad Dermatol. 2005; 52:534–535.