[Cutaneous and visceral loxoscelism: a systematic review]

Abstract

Introduction: Loxoscelism represents a major public health problem for which there are no standard therapeutic interventions.

Objective: To review available scientific evidence on management of Loxoscelism

Method: Systematic review of clinical studies. The search included multiple databases (Medline, Lilacs, Embase, Web of Sciences, Cinahl, Pre-Cinahl, Paperfirst, Proceedingsfirst, Dissertations and Theses, Toxline, Cochrane Library), handsearch of references, and contact with experts.

Results: Three clinical trials of poor methodological quality were identified from 5,207 references found. One trial (n = 31), concluded that the use of dapsone was associated with fewer local complications than surgical treatment. A second study (n = 46), concluded that the use of dapsone was superior to clorfenamine for skin lesions. A third study (n = 95) concluded that there was no differences between the use of oral dapsone, antivenom against anti-Loxosceles reclusa or a combination of both.

Conclusions: There is insufficient evidence based on good quality studies to recommend treatment guidelines for individuals with skin or visceral loxoscelism.