{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,3,12]],"date-time":"2025-03-12T04:13:50Z","timestamp":1741752830889,"version":"3.38.0"},"reference-count":13,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2013,6,1]],"date-time":"2013-06-01T00:00:00Z","timestamp":1370044800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Wilderness &amp; Environmental Medicine"],"published-print":{"date-parts":[[2013,6]]},"abstract":"<jats:p> Brown recluse spider ( Loxosceles reclusa) envenomations with subsequent necrotic skin lesions occur infrequently, and systemic loxoscelism is rarer still. We report a case of 2 successive developing necrotic lesions, each on adjacent medial aspects of the legs, secondary to presumed Loxosceles envenomation. A 31-year-old man with no significant past medical history presented to the emergency department with 2, large, necrotic lesions, 1 on each medial thigh. They had progressed over the course of 1 month from small blisters to large necrotic lesions with eschar. He underwent surgical debridement without skin grafting with no further complications. Bites from recluse spiders that progress to necrosis usually present as single lesions. The differential diagnoses for a necrotic skin lesion is large. The presence of more than 1 lesion argues against Loxosceles envenomation; however, in the absence of underlying infection, systemic diseases, immunodeficiency, or malignancy, the diagnosis must be considered if the case presents in an endemic area. Brown recluse spiders rarely bite multiple times, thus confounding the diagnosis of an already nonspecific clinical finding. <\/jats:p>","DOI":"10.1016\/j.wem.2012.11.004","type":"journal-article","created":{"date-parts":[[2013,1,24]],"date-time":"2013-01-24T20:03:28Z","timestamp":1359057808000},"page":"132-135","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["Two Successive Necrotic Lesions Secondary to Presumed <i>Loxosceles<\/i> Envenomation"],"prefix":"10.1177","volume":"24","author":[{"given":"David B.","family":"Tarullo","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine, Truman Medical Center, University of Missouri Kansas City School of Medicine, Kansas City, MO"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ryan C.","family":"Jacobsen","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Truman Medical Center, University of Missouri Kansas City School of Medicine, Kansas City, MO"},{"name":"Division of Emergency Medical Services, Children's Mercy Hospital, University of Missouri-Kansas City, Kansas City, MO"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D. Adam","family":"Algren","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Truman Medical Center, University of Missouri Kansas City School of Medicine, Kansas City, MO"},{"name":"Division of Clinical Pharmacology and Medical Toxicology Children's Mercy Hospital, University of Missouri-Kansas City, Kansas City, MO"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2013,6,1]]},"reference":[{"key":"bibr1-jwem201211004","doi-asserted-by":"publisher","DOI":"10.3109\/15563650.2011.635149"},{"key":"bibr2-jwem201211004","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra041184"},{"key":"bibr3-jwem201211004","doi-asserted-by":"publisher","DOI":"10.1016\/j.toxicon.2004.08.022"},{"key":"bibr4-jwem201211004","doi-asserted-by":"publisher","DOI":"10.1603\/033.046.0103"},{"key":"bibr5-jwem201211004","doi-asserted-by":"publisher","DOI":"10.1016\/j.jopan.2005.08.006"},{"key":"bibr6-jwem201211004","doi-asserted-by":"publisher","DOI":"10.1006\/bbrc.1998.9474"},{"key":"bibr7-jwem201211004","doi-asserted-by":"crossref","first-page":"517","DOI":"10.3109\/15563650.2011.586639","volume":"49","author":"Lowry J.A.","year":"2011","journal-title":"Clin Toxicol"},{"key":"bibr8-jwem201211004","doi-asserted-by":"publisher","DOI":"10.1067\/mem.2002.119509"},{"key":"bibr9-jwem201211004","first-page":"341","volume":"9","author":"Wallace J.S.","year":"2010","journal-title":"J Drugs Dermatol"},{"key":"bibr10-jwem201211004","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2004.08.028"},{"key":"bibr11-jwem201211004","doi-asserted-by":"publisher","DOI":"10.1016\/j.toxicon.2011.09.009"},{"key":"bibr12-jwem201211004","doi-asserted-by":"publisher","DOI":"10.3122\/jabfm.17.5.347"},{"key":"bibr13-jwem201211004","doi-asserted-by":"publisher","DOI":"10.1016\/j.jemermed.2009.08.055"}],"container-title":["Wilderness &amp; Environmental Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1080603212003699?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1080603212003699?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1016\/j.wem.2012.11.004","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1016\/j.wem.2012.11.004","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1016\/j.wem.2012.11.004","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,11]],"date-time":"2025-03-11T04:10:26Z","timestamp":1741666226000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1016\/j.wem.2012.11.004"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,6]]},"references-count":13,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2013,6]]}},"alternative-id":["10.1016\/j.wem.2012.11.004"],"URL":"https:\/\/doi.org\/10.1016\/j.wem.2012.11.004","relation":{},"ISSN":["1080-6032","1545-1534"],"issn-type":[{"type":"print","value":"1080-6032"},{"type":"electronic","value":"1545-1534"}],"subject":[],"published":{"date-parts":[[2013,6]]}}}