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On-line version ISSN 1806-4841
An. Bras. Dermatol. vol.86 no.4 Rio de Janeiro July/Aug. 2011
Maria do Carmo Araújo Palmeira QueirozI; Juliana Nascimento de Andrade Rabelo CaldasII
IDermatologist 1 Federal University of Rio Grande do Norte; Full Member of the Brazilian Society of Dermatology
IIDermatologist - Full Member of the Brazilian Society of Dermatology
With regard to the correspondence with suggestions about the article "Comparative Dermatology: Lesion Caused by Attack of the Portuguese Man-of-War (Physalia physalis)", we thank the valuable comments that only add to the discussion on the subject, but we would like to clarify a few points. Although the word "attack" may seem a bit dramatic, we believe it is an accurate description, since the Portuguese Man-of-War has urticating filaments that "fire", in analogy with a "weapon", when in contact with a "prey". Common occurrences in our environment, such as when children are stung by Man of War with dramatic results and when bathers get in "not-so-safe" waters and end up suffering multiple injuries, also come to mind.
We are thankful for the information that the antivenom serum for cnidarians is only available in Australia and is unavailable in Brazil.
In relation to treatment, when we conducted the literature review, the few articles we found on the subject suggested the removal of nematocysts with blunt objects. In the book Fischer AA. Atlas of Aquatic Dermatology. 1st ed. New York: Grune & Stratton, 1978 (reference number 5) and in the article: Cristian VK, Marianne KR, Maria Soledad ZT, VK Francisco, Juan Pedro LJ. Jellyfish sting: actualization. Rev Med Chile 2004; 132:233-41 (reference number 2), the use of isopropyl alcohol, talc, sodium bicarbonate and shaving cream is cited. While these may be considered old behaviors, we think they are sufficiently relevant to be mentioned, because these accidents occur at beaches where these may be the only resources availa ble. In fact, cold sea water often cannot be used at the time of the accident due to the fact that most waters on our coast are warmer.
We stress that corticosteroid therapy should be adopted seeking anti-inflammatory, and not only immunosuppressive, action; indeed, its use is mentio ned in reference number 3: Haddad V Lupi O; Lonza JP; tyring SK. Tropical dermatology: Marine and aquatic dermatology. J Am Acad Dermatol 2009; 61 (5) :733-59.
We are aware of the following website http://www.sbd.org.br/down/ANIMAISmarinhosfolheto.pdf, and find it interesting as material to divulge information to the general public.
Maria do Carmo Queiroz Araujo Palmeira
Juliana Nascimento Rabelo Caldas de Andrade