Skin lesions caused by Scorpaena sp. (scorpionfish) stings

BACKGROUND: Scorpaenidae are a family of marine venomous fish. Geographical distribution of these fish includes Eastern Pacific Ocean, Western Atlantic Ocean and Mediterranean Sea. METHODS: We observed eight Caucasian, adult patients with skin lesions caused by Scorpaena sp. stings. Five patients were fishermen, two swimmers and one scuba diver. All patients were stung in Italian seas. In four patients it was possible to capture the fish responsible for skin lesions: it was classified as S. scrofa Linnaeus, 1758. RESULTS: In four patients, hands were involved, in four patients one foot. Two patients developed an erythematous-ulcerated nodule on a hand and one patient developed an ulcer with fibrinous-purulent bed on a toe. All patients complained with local and severe pain. All patients were treated with hot water soaks. The three patients with ulcers were treated with packs of sodium hypochlorite solution, a gel containing equine catalase and a cream with polyhexamethylene biguanide. All patients were treated with oral analgesics. Tetanus prophylaxis were carried out in two patients. In patients with erythematous-edematous lesions, complete remission occurred in 3-7 days. The three patients with ulcers recovered within six weeks. Follow-up was negative in all patients. CONCLUSIONS: Although injuries from Scorpaena sp. stings are rare, they can result in significant local symptoms and, in some cases, systemic effects. Awareness of this risk among swimmers, divers, and fishermen is essential for timely diagnosis and treatment.