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includes very careful removal of visible spines (with par- 8. Liram N, Gomori M, Perouansky M. Sea urchin puncture
ticular attention to avoid fracturing spines by torsion resulting in PIP joint synovial arthritis: case report and
or grasping too tightly with mechanical instruments), MRI study. J Travel Med. 2000;7:43–45.
cleansing the wound, and the application of anti-inflam- 9. Schefflein J, Umans H, Ellenbogen D, Abadi M. Sea ur-
matory agents and analgesia. Antibiotic prophylaxis chin spine arthritis in the foot. Skeletal Radiol. 2012;41:
1327–1331.
should be considered, especially in military scenarios 10. Burke WA, Steinbaugh JR, O’Keefe EJ. Delayed hypersen-
where local wound care may be problematic. If chronic sitivity reaction following a sea urchin sting. Int J Derma-
pain develops, this usually indicates retained spines. tol. 1986;25:649–650.
Standard surgical excision of retained sea urchin spines 11. de la Torre C, Toribio J. Sea urchin granuloma: histologic
remains a possible treatment approach; however, laser profile. A pathologic study of 50 biopsies. J Cutan Pathol.
ablation and individual spine removal are also feasible, 2001;28:223–228.
resulting in excellent outcomes without leaving a large 12. Sciani JM, Zychar BC, Gonçalves LR, et al. Pro-inflam-
surgical wound. The optimal timing for laser ablation matory effects of the aqueous extract of Echinometra
and removal remains unknown, but several case reports lucunter sea urchin spines. Exp Biol Med (Maywood).
demonstrate that good results are achieved when the 2011;236:277–280.
intervention takes place several weeks later, after the 13. de la Torre C, Vega A, Carracedo A, et al. Identification
chronic inflammatory response has begun. 15,16 Laser ab- of Mycobacterium marinum in sea urchin granulomas. Br
J Dermatol. 2001;145:114–116.
lation should be considered an alternative to standard 14. Schillaci D, Arizza V, Parrinello N, et al. Antimicrobial
surgical excision. and antistaphylococcal biofilm activity from the sea ur-
chin Paracentrotus lividus. J Appl Microbiol. 2010;108:
17–24.
Disclosures
15. Gargus M, Morohashi D. A sea-urchin spine chilling rem-
The authors have nothing to disclose. edy. N Engl J Med. 2012;367:1867–1868.
16. Gungor S, Tarikçi N, Gokdemir G. Removal of sea ur-
chin spines using erbıum-doped yttrium aluminum garnet
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