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Clinical Toxicology of Sea Urchin and Starfish Injuries
Published in Jürg Meier, Julian White, Handbook of: Clinical Toxicology of Animal Venoms and Poisons, 2017
Pedicellariae are small delicate organs which consist of two parts, a thin stalk with a terminal head (Figure 2). Two to four (but most often three) pincer-like calcareous valves or jaws are covered by venom-producing glandular tissue. Venom ducts empty near the fanglike tip of the valves. Muscles move the valves which act as pincers seizing prey when touching the pedicellariae. Venom is injected and the prey is paralyzed. Pedicellariae of most sea urchins are not able to penetrate the human skin; however, those of some species (Toxopneustes sp.) are extraordinarily large and able to inject venom even through human skin2.
Sea urchin injuries: a review and clinical approach algorithm
Published in Journal of Dermatological Treatment, 2021
Ziv Schwartz, Marc Cohen, Shari R. Lipner
An algorithmic approach to workup and treatment is warranted to reduce the possibility of complications (Figure 4). Immediately after injury, treatment steps include pedicellariae removal, spine extraction, and immersion in hot water. These should occur in rapid sequence. In the rare event of an injury by a specie with pedicellariae, removal of the pincers is necessary since toxins continue to be secreted while attached. This can be achieved by irrigation and traction (3). Rapidly extractable spines should be removed at this time (2). Immersion in hot water (maintained at 110–115 F, or as hot as tolerable without scalding) should follow for a duration of 30–90 min to inactivate toxins and proteinaceous irritants (5). Some sources recommend mixing the water with vinegar in a 1:1 ratio (3). Any signs of severe systemic response, including hypotension and muscle weakness, should initiate transfer to a hospital setting for respiratory support. Alternative sources of injury should be ruled out since only about 80 (2) of more than 1000 species (49) of sea urchin are toxic. If the source of injury is not clear based on history and injury pattern, treatment for other marine envenomations should be considered, which may require limb pressure immobilization, local suction, antivenin, and respiratory support (5).