II. Pathophysiology

  1. Predominately fresh water exposure
    1. Distribution
      1. Northern United States
      2. Canada
    2. Episodic outbreaks related to snail maturation
      1. Bright, warm days of summer induce snail shedding
      2. Most outbreaks occur near shore
  2. Inflammatory reaction to parasitic cercariae (larvae)
    1. Carriers: Snails
    2. Organisms
      1. Non-human schistosomes (parasitic flatworm)
      2. Flukes
    3. Mechanism
      1. Larvae penetrate Epidermis with water evaporation
      2. Larvae die once embedded
      3. Inflammatory reaction depends on sensitization

III. Symptoms and symptoms

  1. Areas affected limited to exposed areas
  2. Initial Pruritus from acute Urticarial reaction
    1. Pruritus within 1 hour (minimal to intense)
  3. Later papular eruption occurs
    1. First Exposure
      1. Papules within 5 to 13 days
    2. Subsequent Exposure (Sensitized)
      1. Pruritic Papules within hours
      2. Symptoms peak within 2-3 days
      3. Resolution within 7 days

IV. Differential Diagnosis

  1. Seabather's Eruption (limited to bathing suit area)
  2. Aquagenic Pruritus

V. Management: Symptomatic for Pruritus

  1. Antihistamines
  2. Cool compresses
  3. Sarna or Calamine lotion
  4. Low to medium potency Topical Corticosteroids

VI. Complications

  1. Secondary infection related to excoriation

VII. Prevention

  1. Dry Skin immediately after bathing

VIII. Course

  1. Lesions clear completely in 1 to 2 weeks

IX. References

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Ontology: Cutaneous schistosomiasis (C0546996)

Definition (NCI) An unusual presentation of schistosomiasis characterized by a pruritic papular rash in the perigenital or periumbilical area due to an allergic reaction to schistosoma eggs deposited in the skin.
Concepts Disease or Syndrome (T047)
ICD9 120.3
ICD10 B65.3
SnomedCT 86711009, 238534006, 187115002
English Schistosoma cercarial dermatit, cutaneous schistosomiasis (diagnosis), cutaneous schistosomiasis, schistosomiasis dermatitis ('swimmer's itch'), Schistosomiasis cutaneous, Cutaneous schistosoma, swimmer itch, cercarial dermatitis, itch swimmer's, sea bather's eruption, swimmers' itch, itch swimmers, swimmer's itch, Infection by cercariae of schistosoma (disorder), Marine dermatitis, Cercarial dermatitis, Sea bather's eruption, Swimmer's itch, Schistosome dermatitis, Clam digger's itch, Cutaneous schistosomiasis, Infection by cercariae of schistosoma, Swamp itch, Clam-digger's itch, Schistosomal cercarial dermatitis, Swimmers' itch, Cutaneous schistosomiasis (disorder), Sea bather's eruption (disorder), cercarial; dermatitis, clam digger's; itch, cutaneous; schistosomiasis, dermatitis; cercarial, Schistosoma; cercariae, itch; clam digger's, itch; swimmer's, schistosomiasis; Schistosoma cercariae, schistosomiasis; cutaneous, Infection by cercariae of schistosoma (disorder) [Ambiguous], Cutaneous Schistosomiasis, Infection by cercariae of Schistosoma
Italian Schistosomiasi della pelle, Schistosomiasi cutanea
Dutch cutane schistosomiasis, Schistosoma; cercariën, cercaria; dermatitis, cutaan; schistosomiasis, dermatitis; cercaria, itch; swimmer's, jeuk; schelpengraver, schelpengraver; jeuk, schistosomiasis; Schistosoma-cercariën, schistosomiasis; cutaan, Cercariën-dermatitis, huidschistosomiasis
French Schistosomiose cutanée, Bilharziose cutanée
German kutane Schistosomiasis, Zerkariendermatitis, Schistosomiase der Haut
Japanese 皮膚住血吸虫症, ヒフジュウケツキュウチュウショウ
Czech Kožní schistozomóza
Korean 꼬리유충 피부염
Hungarian cutan schistosomiasis, Cutan schistosomiasis
Spanish dermatitis cercariana, dermatitis esquistosómica, prurito del nadador, prurito de los pantanos, infección por cercarias de esquistosoma (trastorno), infección por cercarias de esquistosoma, erupción del bañista, dermatitis del nadador, dermatitis marina (trastorno), dermatitis marina, dermatitis por cercarias, esquistosomiasis cutánea (trastorno), esquistosomiasis cutánea, infección por cercarias de esquistosoma (concepto no activo), infección por cercarias de schistosoma, Esquistosomiasis cutánea
Portuguese Schistosomíase cutânea