Seabather’s eruption from the Mediterranean Sea

Background: Seabather’s eruption (SBE) is an acute dermatitis characterized clinically by erythematous papules located almost exclusively under a bathing suit. SBE is caused by contact on the skin by the jellyfish, Linuche unguiculata (L. unguiculata). Objectives: To report our clinical experience of SBE, with a description of the presentation of the first SBE cases from the Mediterranean Sea. Materials & Methods: In the period 1987-2023, we observed seven patients with SBE; four males and three females, with an age ranging from 16 to 56 years (mean age: 37.2 years). Results: All patients contracted SBE in the Mediterranean Sea, which was characterized by a typical clinical picture of erythematous papules located almost exclusively under the bra or underpants, accompanied by severe pruritus. Conclusion: In all patients, SBE showed a typical clinical presentation and it was possible to exclude other diagnoses, such as swimmer’s itch, folliculitis, acne/acneiform eruptions, and follicular larva migrans. No cases of SBE have been previously reported from patients swimming in the Mediterranean Sea. L. unguiculata may have reached the Mediterranean Sea from the Atlantic Ocean, however, it is also possible that SBE in our patients was caused by different microorganisms other than L. unguiculata, supporting the hypothesis, as previously suggested, that SBE can be caused by microorganisms other than L. unguiculata.