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Fig 1.

Study flow chart.

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Table 1.

Baseline characteristics of patients with loxoscelism.

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Fig 2.

Marbled macula, with and without erythematous halo, after a Loxosceles sp. bite.

(a) 18 h after the bite; (b) 24 h after the bite; (c) 72 h after the bite; (d) 120 h after the bite.

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Fig 3.

A patient bitten at two sites on the right arm.

Marbled maculae on the forearm (a) and the upper arm (b), 4 days after a Loxosceles sp. bite. (c) Necrotic lesion on the upper arm and forearm 19 days after the bite.

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Fig 4.

Evolution of a cutaneous lesion after a Loxosceles sp. bite.

(a) marbled macula with blister, 7 days after the bite; (b) cutaneous lesion with a ruptured blister, 12 days after the bite; (c) eschar, 32 days after the bite.

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Fig 5.

Evolution of a cutaneous lesion after a Loxosceles sp. bite, from marbled macula to necrosis and ulcer.

(a) 4 days after the bite; (b) 17 days after the bite; (c) 24 days after the bite; (d) 31 days after the bite.

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Fig 6.

Evolution of the cutaneous lesion after a Loxosceles sp. bite in a patient with cutaneous-hemolytic loxoscelism.

(a) 8 days after the bite; (b) 17 days after the bite; (c) 24 days after the bite; (d) 52 days after the bite.

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Fig 7.

Evolution of a cutaneous lesion after a Loxosceles sp. bite, from marbled macula to necrosis and ulcer.

(a) 5 days after the bite; (b) 20 days after the bite; (c) 27 days after the bite, the patient presented an ulcer at the bite site and scaling on the hands; (d) 83 days after the bite, the patient had a scar at the site of the bite but opted not to undergo plastic surgery.

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Table 2.

Systemic manifestations observed at hospital admission.

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Table 2 Expand

Fig 8.

Evolution of a cutaneous lesion after a Loxosceles sp. bite.

Marbled macula at the bite site (a), rash on the forearm (b), and rash on the abdomen (c), 4 days after the bite. (d) Persistence of the rash on the abdomen at 7 days after the bite.

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Fig 9.

Rash on the thighs and palmar erythema in a patient bitten by a Loxosceles sp. spider, 4 days after the bite.

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Fig 10.

Patients bitten by a Loxosceles sp. spider and presenting desquamation on the feet and hands.

(a) 17 days after the bite; (b) 24 days after the bite; (c) 36 days after the bite.

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Table 3.

Duration of systemic manifestations.

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Table 4.

Comparison between patients who developed skin necrosis and those who did not.

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Table 5.

Frequency of cutaneous necrosis among patients who did and did not receive anti-arachnid serum, by the time from bite to antivenom administration.

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