“…The initial interaction between the venom and tissues causes complement activation, migration of polymorphic neutrophils, liberation of proteolytic enzymes, cy-tokine and chemokine release, platelet aggregation, and blood flow alterations that result in edema and ischemia, with development of necrosis (2). The first situation, which is more common (67-100%), is characterized by the presence of painful cutaneous lesion, of slow and gradual evolution, where signs such as edema, induration, erythema, ischemia, ecchymosis, and mixed area of erythema, ecchymosis, and ischemia, known as red, white, and blue sign, appear (3,5,6). Previous studies have reported that, over the next 5 days, there is a massive neutrophilic infiltration into the dermis and subcutaneous muscle, with vessel destruction, thrombosis, hemorrhage, myonecrosis, and coagulative necrosis (1).…”