Hand rot????

Ok, the last few weeks my hands have been blistered, swollen, red, itchy, burning agggggggghhhhhH!!!!!!! What is causeing this??????

Eureeeeekkkkkkkaaaaaaaaaaaa!!!!

After my mother tried to tell me she thought it was something in the fish tank, I told her she was crazy. Then Dr. Sabo, asked her if I had an aneome in my tank..(yes, 2) she came home and told me again….so to prove them wrong I decided to do some research….. oooooppppsss I was wrong.

My findings:
After swimming in the ocean and coming into contact with marine life, the patient may seek medical attention because of local pain or swelling or skin discoloration. Marine animal envenomations can be divided into two major categories: puncture wounds and focal rashes. Severe envenomations can be accompanied by systemic symptoms like vomiting, paralysis, seizures, respiratory distress and hypotension, but this review is limited to the more common local injuries.
Focal rashes:

* Contact with a bristleworm is followed by an intense red, itchy rash.
* Contact with feather hydroids and sea anemones induce a mild reaction, consisting of instantaneous burning, itching and urticaria. The reaction may be delayed and can include the appearance of papules, hemorrhagic vesicles or zoster-like reactions 4 to 12 hours after contact.
* The sting of the fire coral induces intense burning pain, with central radiation and reactive regional lymphadenopathy.
* Most of the jellyfish with suspended tentacles create “tentacle prints” or a whip-like pattern of darkened reddish brown, purple or frosted and cross-hatched stripes in the precise areas of skin contact. Vesiculation and skin necrosis may follow.

What not to do:

* Do not use fresh water to decontaminate stings. It may cause microscopic cysts to swell and rupture and trigger additional stinging. I DID
* Do not use topical or systemic corticosteroids for puncture wounds unless there is an allergic reaction. I DID
* Do not constrict limbs tightly. I DID,I DID,I DID,I DID,I DID

What to do:
Focal rashes:

* For fire coral, jellyfish, hydroid or sea anemone stings, decontaminate the area with a liberal soaking of 5% acetic acid (vinegar). The leading alternative is 40-70% isopropyl (rubbing) alcohol. Apply continuously for 30 minutes or until the pain disappears.
* After decontamination, remove any visible large tentacles with forceps or doubly-gloved hands. Remove small particles by applying shaving foam or some equivalent and gently shaving the area with a safety razor, dull knife or plastic card, then clean with an antibacterial soap and flush with water or saline solution.
* Treat any generalized allergic reactions with antihistamines, corticosteroids and epinephrine.
* When irritation from sponges, bristle worms or other marine creatures cause erythematous or urticarial eruptions, it usually means tiny spicules and spinules are embedded in the skin. Dry the skin and apply the sticky side of a piece of adhesive tape to the affected area and peel the tape back to remove these particles.
* Residual inflamation can be treated with topical corticosteroids like Aristocort A 0.1% or 0.5% cream or Topicort emollient cream or ointment 0.25% (dispense 15 grams and apply tid-qid). A topical steroid in combination with a topical anesthetic can be additionally soothing (eg Pramosone cream, lotion or ointment 2.5% or Zone-a-cream 1% tid-qid).
* Check wounds for infection in two and seven days.

So there you have it…. memorize this information….you never know when you’ll be walking down the street and be attacked by a gangsta sea anemone!!!!

Later,
JC