Spider Bites Might Present as Cellulitis Like in Early Cases and Pyoderma Gangrenosum Like in Late Cases

Background: Spiders are blamed for all kinds of things that turn out to be simple infections or some other bugs faults as most are harmless bite except two spiders, the black widow and brown recluse that might cause reaction locally as ulcers and systemic beyond the bite like abdominal pain, cramps or respiratory problems. Materials and Methods: Twenty-four patients with history of spider bite were recorded during the period from May 2012 to March 2020, their ages ranged from 25-35 years five females and 19 males. All cases were seen three-15 days after biting and no one examined at the time of bite. On careful questioning of patients, many had seen brown-black spider while others had felt a bite only. Results: On careful examination, the lesional bites could be divided into early and late presentations. Regarding the early presentation in six cases were observed and all had cellulitis like picture with small black necrosis at the center while the late cases showed gangrenous well defined ulcer that simulate pyoderma gangrenosum in (18) patients and these ulcers were characteristically polygonal in shapes at their margins. The sites of these bites were as follow: 14 (58.3%) thighs including groins, 3 (12.5%) legs, 3 (12.5%) fingers, 3 (12.5%) male genitalia and one (4.16%) was left axilla. Medical management including topical antiseptic together with topical and oral antibiotic cover with oral antihistamine and oral prednisolone. The duration of therapy depending on the size of ulcer but generally it took from two weeks to two months. No surgical debridement was carried out. Conclusion: Spider bites are commonly seen adult males and could be presented as early cellulitis like and late polygonal pyoderma gangrenosum like. The commonest sites affected were lower limbs, most commonly thighs and groins. Healing might take few weeks to few months depending on the size of necrotic ulcer. Wound debridement was not carried out but skin grafting might be suggested for large ulcer as to reduce the time of morbidity and recovery. Keywords: Spider bite, Pyoderma gangrenosum, Ulcer