A 57-year-old woman presented with a widespread papulonodular eruption. The
dermatitis had appeared about 1 week after her return from a trip to the R
ed Sea, where she had come into contact with a shoal of unidentified jellyf
ish; however, that contact had not been followed by cutaneous lesions and/o
r symptoms. The patient also stated that she had had previous contacts with
jellyfish during other trips to exotic seaside resorts.
The dermatitis was characterized by papulonodular lesions, round or oval in
shape, of a few millimeters in diameter, with a color ranging from pink to
red to brown, and with a smooth and regular surface. The lesions were grou
ped in an apparently random fashion (Fig. 1) or arranged linearly (Fig. 2).
The patient complained of pruritus and burning.
Histopathologic examination showed the presence of some necrotic keratinocy
tes; in the upper and mid dermis, edema and a predominantly perivascular an
d periadnexal lymphohistiocytic infiltrate, with numerous neutrophils and e
osinophils, were observed (Fig. 3).
The patient was treated with hydroxyzine (37.5 mg/day) and hydrocortisone b
utyrate, which resulted in the rapid disappearance of the symptoms; however
, the cutaneous lesions persisted for about 3 weeks.