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Occupational and recreational aquatic activity predisposes our population to a wide variety of dermatoses. Sunburn, urticaria, jellyfish stings, and contact dermatitis to rubber equipment are common allergies that are encountered in the aquatic environment. Among the infections, tinea versicolor, intertrigo, and verruca vulgaris are widespread. Swi...
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... Aquagenic urticaria is a rare form of physical urticaria that occurs upon contact with water from any source or of any temperature. [32] Clinical features: The presence of urticarial wheals differentiates the condition from aquagenic pruritus [ Figure 3]. The condition may be further differentiated from cold-induced urticaria by placing an ice cube wrapped in a plastic bag over the forearm and looking for a wheal at the site upon rewarming the skin. ...
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... Significant itch develops over several hours, with discrete erythematous papules which may lead to blistering if severe. 9 The rash usually resolves within one to three weeks. 2 The diagnosis is clinical. ...
Cutaneous schistosomiasis (swimmer’s itch) is an itchy maculopapular rash that follows skin penetration by cercariae of nonhuman schistosomes, during fresh or brackish water exposure. It is typically a mild skin reaction that settles in one to three weeks. Here we describe a case of severe swimmer’s itch acquired in Victoria, Australia, with widespread bullous lesions on water-exposed areas of skin. This case presented a diagnostic challenge and is unique given the severity of the reaction and the geographic occurrence; the condition rarely causes bullae, and to date has been reported only in more northern latitudes of Australia. With climate change trends, swimmer’s itch is likely to become increasingly prevalent in more temperate regions, illustrating the importance of clinician awareness of this condition.
... SBE has persisted for longer than a month in some patients(77). Though rarely seen, patients with SBE can develop systematic symptoms of fever, nausea, cramps, and vomiting(79).TreatmentTreatment for SBE should begin with cnidarian decontamination with a 5% acetic acid wash(77). Following decontamination, pruritic and inflammatory symptoms should be treated with systemic antihistamines and topical corticosteroids(77). ...
In this paper, we discuss pertinent cutaneous findings that patients may present following travel to tropical destinations. We address arthropod-borne infectious diseases such as Cutaneous Leishmaniasis, Chagas Disease, Cutaneous Larvae Migrans, Myiasis, and others. We discuss other relevant diseases with cutaneous signs such as Monkey Pox and SARS-CoV-2. We provide clinicians with information regarding the background, diagnosis, treatment, and prevention of these tropical rashes. Additionally, we address the impact that climate change will have on the temporal and geographic incidence of these rashes. Viral, fungal, and vector-borne diseases have seen a geographic expansion into more northern latitudes. Among these are tick-borne Lyme disease, aquatic-snail-related Sea bather's eruption, and atopic dermatitis. As these diseases spread, we believe the updated information within this article is significant to the practicing physician in today's warming world.
... It has been found that fluctuations in the ambient environment are associated with heart disease and death [45]. Fishermen are very prone to sunburn [46]. Most often, exposure to sunlight leads to premalignant and malignant lip lesions in fishermen. ...
In developing countries such as China, commercial fishermen’s occupational health risks are rarely studied despite being extremely critical for the sustainable development of the fisheries sector. In this study, we attempt for the first time to categorize and prioritize multiple types of health risks posed by these fishermen. This was accomplished by conducting a structured questionnaire survey between 9 January 2022 and 24 May 2022. We sought the professional opinion of fishermen that were located in the coastal areas of Zhejiang, China, namely Zhoushan (121 responses, 64%), Taizhou (66 responses, 49%), and Wenzhou (94 responses, 53%). This study used two hundred eighty-one questionnaires with a consistency ratio (CR) below 0.1 and completed in every respect. Fuzzy Analytical Hierarchical Process (Fuzzy AHP) and Importance Performance Analysis (IPA) statistics were employed to perform statistical analysis. Results have revealed that commercial fishermen’s health is affected by five main risk factors, namely natural (0.058), biological (0.088), social (0.152), psychological (0.234), and physical (0.468), which are arranged from the least to the most significant risk factors. As for the performance of the main risk factors, the physical risk was ranked first (4.786), followed by social risk (4.571), psychological risk (4.214), biological risk (4.000), and natural risk (3.429). These research findings can serve as guidelines for managers. Moreover, this study discusses ramifications, constraints, and proposals for future research.
... Lesions could also be found in flexural regions. Chills, fever, nausea, vomiting, diarrhea, headache, and abdominal pain are found on rare occasions and usually occur in children or cases of severe envenomation [76,175]. ...
... According to Center for Disease Control recommendations, tetanus prophylaxis is indicated whenever there is a minor wound, and the patient is not up to date with the tetanus vaccination scheme. As such, tetanus prophylaxis must also be considered [6,76,206]. ...
... Swimmers affected by seabather s eruption should remove their swimsuit prior to showering, as the fresh water may cause further discharge. The swimwear must be thoroughly washed with soap before reuse to eliminate any remaining larvae [76,220]. ...
Jellyfish are ubiquitous animals registering a high and increasing number of contacts with humans in coastal areas. These encounters result in a multitude of symptoms, ranging from mild erythema to death. This work aims to review the state-of-the-art regarding pathophysiology, diagnosis, treatment, and relevant clinical and forensic aspects of jellyfish stings. There are three major classes of jellyfish, causing various clinical scenarios. Most envenomations result in an erythematous lesion with morphological characteristics that may help identify the class of jellyfish responsible. In rare cases, the sting may result in delayed, persistent, or systemic symptoms. Lethal encounters have been described, but most of those cases happened in the Indo-Pacific region, where cubozoans, the deadliest jellyfish class, can be found. The diagnosis is mostly clinical but can be aided by dermoscopy, skin scrapings/sticky tape, confocal reflectance microscopy, immunological essays, among others. Treatment is currently based on preventing further envenomation, inactivating the venom, and alleviating local and systemic symptoms. However, the strategy used to achieve these effects remains under debate. Only one antivenom is currently used and covers merely one species (Chironex fleckeri). Other antivenoms have been produced experimentally but were not tested on human envenomation settings. The increased number of cases, especially due to climate changes, justifies further research in the study of clinical aspects of jellyfish envenoming.
... Human infections typically occur several weeks after exposure of wounded skin to contaminated water, or after handling fish (2)(3)(4)(5)(6). Lesions can be solitary or multiple, and a linear distribution of papulonodular lesions along lymphatic channels, resembling sporotrichosis, can occur in up to one-third of cases, due to lymphatic spread (7). ...
... Cutaneous adverse events can occur in participants of aquatic sports [1]. The causative activity can be located either at a pool or on the beach or in the water [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20]. A 27-year-old man who developed beach feet (hot sand-associated superficial thermal burns on the soles of his feet and the plantar aspects of his toes after running with his dog on the beach) is described, and other beach sports-related dermatoses are summarized. ...
... Injury can result from skin penetration, stings or envenomation. Coral and sponges can also cause abrasions and dermatoses [17][18][19][20]. ...
Athletes may develop sports-related dermatoses. Indeed, participants of aquatic-associated sports can experience dermatologic conditions that affect their feet when they play barefooted on the beach. These disorders are variable in etiology and include traumatic injury to the unprotected feet and toes, penetration of organisms (such as hookworm larva and schistosomiasis cercaria) into the feet and toes, and ultraviolet radiation-related maladies such as an acute phototoxic reaction (sunburn) and thermal injury from contact with hot sand. Indeed, exposure to hot sand can result in first-degree, second-degree or rarely third-degree burns. A 27-year-old man developed painful erythematous patches on the plantar feet and toes after running barefoot on the sand during a hot August afternoon on a dog beach in Del Mar, California. To emphasize both the injury-causing environment and the affected location, beach sand-associated thermal injury to the soles of the feet and the plantar aspects of the toes is referred to as beach feet.
... Wastewater and storm-water runoff are not the only sources of potential pathogens in ocean water. Naturally occurring bacteria, such as Vibrio species and Mycobacterium species, are found in marine environments all over the world and can cause human disease (Sridhar and Deo, 2017;Yu, 2018). Environmental parameters (e.g. ...
... Furthermore, the extensive use of antibiotics has affected environmental bacteria, including Vibrio species, rendering them more resistant to antibiotics which makes treating these skin infections especially difficult (Han et al., 2007). Naturally occurring atypical Mycobacterium species, such as Mycobacterium marinum and Mycobacterium scrofulaceum, have been associated with skin infections directly related to aquatic exposure (Griffith et al., 2007;Sridhar and Deo, 2017). These organisms can cause self-limiting, slowly-healing ulcers as well as more invasive health effects (e.g. ...
Skin is the body's first line of defense against invading microorganisms. The skin microbiome has been shown to provide immunity against exogenous bacterial colonization. Recreational water exposures may alter the skin microbiome and potentially induce skin infections. This study explored the link between ocean water exposures and the human skin microbiome. Skin microbiome samples were collected, using swabs, from human participants' calves before and after they swam in the ocean, and at 6 hour and 24 hour post-swim. Genomic analysis showed that skin microbiomes were different among individuals before swimming. But after swimming, microbial communities were no longer different, which was demonstrated by a decrease in inter-sample diversity. Taxonomic analysis showed that ocean bacteria, including potential pathogens, replaced the native skin bacteria and remained on the skin for at least 24 hour post-swim. This research provides insight into the relationship between the human skin microbiome and the environment.
... It causes infections in fish and can also cause opportunistic infections in humans [1][2][3][4]. Human disease produces nodular or ulcerating skin lesions, occurring mainly over the extremities (especially fingers and bony prominences) with onset after an incubation period of two to 6 weeks [5,6]. A sporotrichoid pattern may be seen in up to one-third of the cases owing to lymphatic spread [6]. ...
... Human disease produces nodular or ulcerating skin lesions, occurring mainly over the extremities (especially fingers and bony prominences) with onset after an incubation period of two to 6 weeks [5,6]. A sporotrichoid pattern may be seen in up to one-third of the cases owing to lymphatic spread [6]. Invasive infections such as tenosynovitis, septic arthritis, and osteomyelitis are uncommon [7]. ...
Mycobacterium marinum is a nontuberculous mycobacteria with worldwide distribution that lives in fresh or salt water and is responsible for infections in fish, and sometimes in humans. Human disease consists mainly of cutaneous nodules, but deep structure involvement may also occur. Diagnosis of M. marinum infection remains a challenge, with a considerable time delay between onset of symptoms and diagnosis. We present a 33-year-old man with no immunosuppressive history who was seen in our department with skin nodules over his hand and forearm, distributed in a sporotrichoid pattern. His hobbies included maintaining an aquarium of tropical fish. Histological examination of the patient's skin biopsy was compatible with the diagnosis of mycobacterial infection, and the Ziehl-Neelsen staining revealed acid-fast bacilli. Molecular techniques confirmed the suspicion of M. marinum infection. A necropsy was performed on one of the patient's fish, more specifically, a Poecilia reticulata, and resulted in identification of M. marinum from its gut. The patient was treated with clarithromycin, ethambutol, and rifampicin for 9 months, with clearance of infection.
... Among water-borne eruptive skin conditions caused by a large variety of aquatic organisms including bacteriae, cyanobacteriae, fungi, algae, and cnidarians, cercarial dermatitis (CD), generally known as swimmer's itch, has been frequently recognized in both freshwater and marine ecosystems worldwide Sridhar and Deo 2017). It is a manifestation of a skin immune reaction provoked by antigens of penetrating infective stages (cercariae) of schistosome flukes (Trematoda: Schistosomatidae) (Kolářová et al. 2013). ...
Abstract
Cercarial dermatitis (CD) is an allergic skin disease that rises in consequence of infection by invasive stages (cercariae) of trematodes of the family Schistosomatidae. CD has been considered a re-emerging disease, human cases have been reported from all continents, and tourism-threatening outbreaks occur even in frequented recreational areas. Although the symptoms of CD are generally known, the data on immune response in human patients are sporadic and incomprehensive. In the present study, we attempted to correlate the symptoms, personal history, and time course of CD in human patients with differential cell counts, dynamics of selected cytokines, and dynamics and quality of antibody response. By a systematic follow-up, we obtained a uniquely complex dataset from ten persons accidentally and concurrently infected by the same parasite species in the same locality. The onset of CDwas significantly faster, and the symptoms were heavier in participantswith a history of CD if compared to naive ones, who, however, also developed some of the symptoms. The repeatedly infected persons had elevated proportion of eosinophils 1 week post exposure (p.e.) and a stronger specific IgG but not IgM response, whereas specific IgE response was not observed. Increased serum levels of IL-4 occurred 1 and 3 week(s) p.e. in all participants. There was high variability in individual immunoblot patterns of IgG response, and no antigen with a universal diagnostic potential was confirmed. The presented analyses suggested that a complex approach can improve the accuracy of the diagnosis of CD, but component data should be interpreted carefully.
... Only fishers with serious cases of contact dermatitis may seek hospital care and, thus, be counted as having the condition [35]. Sridhar and Deo reported that common aquatic skin hazards include sunburn, hives (urticarial: itchy patch of skin that turns into swollen red welts), jellyfish stings, wound infections, and rubber contact allergic dermatitis related to diving equipment [36]. ...
The purpose of this literature review, the second in a series following one on traumatic injuries and fatigue, is to identify potential health hazards to inform a study of occupational health and safety among fish harvesters in the Gulf of Mexico (GoM). Fish harvesters are potentially at a high risk of occupational illnesses in GoM fisheries. GoM fishers engage in harvesting shrimp, finfish, oysters, crabs, and clams. Method: The method is a narrative literature review. Search terms that included safety, seafood, occupational, fishing, oyster, clam, shrimp, crab, and GoM were used to identify relevant literature in combination (i.e., a string search). Results: A total of 53 manuscripts were reviewed, of which only two regarded the GoM, but 19 were from the US Atlantic Coast. Musculoskeletal disorders are widespread across the fishing sector. Other hazards include bites and stings from aquatic animals (some of which may be life-threatening), vessel engine noise, dermatoses, and other skin afflictions (including possible strep infection of wounds), solar ray-induced eye diseases, and respiratory exposures (such as to protein aerosols) that can cause asthma. Diving poses multiple breathing and other hazards. Conclusion: While fish harvesters are protected from respiratory problems when working on the well-ventilated deck and dermal hazards by wearing gloves, musculoskeletal, bite and sting, ocular, engine-related hearing loss, and skin, lip, and eye cancer hazards are potentially serious risks among GoM fish harvesters.
