case_images: PMC10885633_01
case_images: Skin lesions resulting from the bite of the Loxosceles spider. A: Lesion located in the inner region of the left thigh, measuring approximately 4 cm in diameter, exhibiting an undefined appearance with the presence of a livedoid plaque characterized by areas of erythema, ischemia, and necrosis, from the periphery to the center. B: Formation of vesicles with serohematic content, with irregular borders, delimited by an area of hyperpigmentation
case_images: 1806-9460-spmj-142-04-e2023151-gf01.jpg
case_images: PMC10885633_01_1806-9460-spmj-142-04-e2023151-gf01.jpg
case_images: f1
case_images: Sixteen hours after the bite, the patient presented with an erythematous lesion measuring 2 cm in diameter with an indurated erythematous perilesional area or a bull's-eye measuring 16 cm in diameter, with irregular edges and considerable pain upon palpation (Figure 1A). After 24 hours, a blister approximately 12 cm in diameter developed on the lesion (Figure 1B).
case_images: Lesion with irregular borders, necrotic background, delimited by an area of hyperpigmentation and erythema, showing exudate coming out of the vesicles
case_images: 1806-9460-spmj-142-04-e2023151-gf02.jpg
case_images: PMC10885633_01_1806-9460-spmj-142-04-e2023151-gf02.jpg
case_images: f2
case_images: Additionally, a livedoid spot appeared (Figure 2).
case_images: Lesion with irregular borders, delimited by a hyperpigmented area with scaly changes, erythema, and an area of central ischemia. A: Erythematous livedoid plaques with fine scaling and central necrotic eschar with accompanying scaling changes. B: Wound in the granulation phase, delimited by an area of hyperpigmentation. C and D: Lesions in the remodeling phase, with perilesional hyperpigmented area
case_images: 1806-9460-spmj-142-04-e2023151-gf03.jpg
case_images: PMC10885633_01_1806-9460-spmj-142-04-e2023151-gf03.jpg
case_images: f3
case_images: Granulox  (hemoglobin spray) (Figure 3A). Granulox  was prescribed for at-home topical treatment every 8 hours for 7 days. The patient returned for a follow-up examination of the lesion (Figure 3B-3D).
case_images: Complete remission of the lesion, discoloration, or formation of mild scar tissue
case_images: 1806-9460-spmj-142-04-e2023151-gf04.jpg
case_images: PMC10885633_01_1806-9460-spmj-142-04-e2023151-gf04.jpg
case_images: f4