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On-line version ISSN 1806-4841
An. Bras. Dermatol. vol.86 no.4 Rio de Janeiro July/Aug. 2011
Vidal Haddad Junior
To the Editor of the Anais Brasileiros de Dermatologia:
I appreciate the answer to my letter and submit the justifications for my suggestions in the form of a response to the authors, restating that this discussion is very valuable and brings new information to the readers of the journal.
1. The term "attack" is not dramatic. It is incorrect. As I previously mentioned, there is no attack of cnidarians. The term "demonizes" the animal, which is not good. I recognize that the occurrences are really dramatic, especially when accidents with children are involved, but there are no attacks and the term should not be used. The tentacles of the animal are used to catch fish. In about 500 accidents by cnidarians, I have never seen one with characteristics of an attack.
2. I acknowledge the excellent literature research conducted by the authors. However, there is some old information and not everything that is said has been proven effective. As a result, it is complicated to disseminate this information to the entire dermatological society. If we do not have any resources available at the site of the accident, it is better not to do anything, since some actions mentioned in the article may aggravate the injury. It was in this sense that I recommended the website. Although it is directed to the general public, it offers proper first aid measures which are currently accepted. The website can also be useful for physicians because these measures are the only ones that exist in Brazil (as previoulsy mentioned, there is no antivenom serum). As for steroids, their use is restricted to chronic allergic reactions, something complex and rarely seen.
Haddad Junior Vidal UNESP / Butantan Institute