A nine-year-old boy surprised pediatrician Milena De Paulis by risking what he had: jellyfish lice. Her surprise was due to two reasons: because the boy took the initiative to search the internet for the cause of the small red blisters on his skin and because he, in a way, got the diagnosis right.
Despite being popularly known as sea lice due to the itch it causes, what motivated the dermatitis recently observed in bathers was the larva of the jellyfish Linuche unguiculata🇧🇷
De Paulis, who is part of the emergency department of the Society of Pediatrics of São Paulo, says that the first cases of itching from the bathing suit began to appear in the offices after the holiday of the Proclamation of the Republic.
“I had never heard of this type of dermatitis and, after treating this nine-year-old patient who had spent the holiday in Santos, I mentioned it to my colleagues on duty. That afternoon alone, they had already treated four other cases”, he recalls.
The pediatrician reported the episode in groups of pediatricians and found that more patients with bathing suit itching had been consulted at other health facilities. With the exception of one child, who had just returned from Rio de Janeiro, all the others assisted were on beaches on the coast of São Paulo.
Although it may be a novelty in offices in São Paulo, the condition is not unprecedented in the country and there is no reason for alarm, say André Morandini, professor and director of the Center for Marine Biology at USP, and Vidal Haddad Júnior, professor of the medical course from Unesp.
Specialist in jellyfish, Morandini says that the species Linuche unguiculate it has a life cycle with alternation of generations, that is, with distinct phases and body shapes. The jellyfish, a phase that lives in the water column, has never been found in the country. What has been reported since 1995 is the phase of the polyps, which grow on rocks.
The species has cells with nematocysts, structures in the form of harpoons that are used for defense and food capture. These structures are capable of injecting tiny drops of toxic substances and they are what cause skin irritations and reactions.
“Here in Brazil, as in some places in the Caribbean, what causes the problem of ‘swimwear rash’ are the larvae of the Linuche unguiculate🇧🇷 These larvae look for a protected place to continue their life cycle and stay under swimsuits and swimming trunks. When the person comes out of the water, the larvae end up being pressed between the bathing suit and the skin. With the pressure, the stinging cells trigger the nematocysts”, explains Morandini.
The attendance data of the last few weeks have not yet been analyzed by the State Department of Health, and Morandini says that there are no studies that indicate an increase or decrease in the number of polyps on the Brazilian coast. “The studies carried out so far are only descriptive, recognizing the presence of the species”, he says.
Thus, it is not possible to know when and where other episodes may occur – between 2001 and 2006, for example, 38 cases were registered in children and adults in Santa Catarina, according to a study published in 2009 by Haddad Júnior.
“The diagnosis is more frequent in children, because they spend more time in the water”, says the dermatologist, who researches clinical and therapeutic aspects of accidents involving aquatic animals.
Parents, however, do not need to restrict their children’s time at sea. Skin irritation is fleeting and the biggest difficulty is controlling the itch so as not to injure the skin.
“Usually, the treatment is done with corticoid, anti-allergy and cold water compress, and the irritation ceases in a week”, says Haddad Júnior.
De Paulis adds that in some cases there may be fever, chills, nausea and vomiting, but this is not the usual picture. “None of the colleagues have so far reported these more systemic signs.”
She advises parents to remove swimsuits, swim trunks, bikinis and T-shirts when the children leave the beach and then wash the body with running water, without rubbing. The idea is to reduce friction and avoid greater contact with the toxins of the larvae. “It’s benign and self-limiting. Parents need not be alarmed.”
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