Case of skin injuries due to stings by crown‐of‐thorns starfish (Acanthaster planci)

Abstract

A case of skin injuries due to stings by crown-of-thorns starfish, Acanthaster planci, in a 53-year-old Okinawan woman is reported. She went to a beach to gather shellfish on 8 April 2001 and fell to the ground with her left palm on a crown-of-thorns starfish that happened to be close to her. She hurried to the emergency section of our hospital. An emergency doctor sterilized the wound and administered an antibiotic, an analgesic agent and an injection of a tetanus antitoxin. He tried to remove the remaining spines from the palm with great difficulty. Because swelling and subcutaneous indurations of the left palm had persisted thereafter, oral and topical administration of corticosteroid started on 13 April. Physical examination at the dermatology section revealed approximately 10 stab wounds of the left palm with pus, subcutaneous bleeding and many abrasions around them. X-rays of the left hand showed foreign bodies, 2-10 mm in size, located on the lesions. The patient was treated with a topical injection of 2 mg triamcinolone acetonide (Kenacort-A), diluted fivefold with 1% Xylocaine, once a week. Some of the foreign body granulomatous lesions improved but pain and subcutaneous indurations persisted in most of the lesions. Because the X-ray photographs showed many remaining spines, surgical excision to remove them was performed under local anesthesia 3 months after the injury. All the symptoms improved after the operation. Scanning electron microscopic examination of the spines revealed that their tips had fragile lattice-like structures.

Hemolytic activity of venom from crown-of-thorns starfish Acanthaster planci spines

“…A previous study also reported that the venom from A. planci spines is unstable in acidic (pH < 3) or alkaline (pH > 10) environments [1]. Our results corroborated the instability of ASV hemolysis in an alkaline environment.…”

“…Our results showed that the venom from the spines of A. palnci from Taiwan exhibits strong hemolytic activity. The venom was characterized as a protein and such results are similar to previous reports [1-3]. …”

“…When R. esculentum venom was incubated at temperatures over 40°C, its hemolytic activity was sharply reduced [12]. A previous study indicated that the venom from the crown-of-thorns starfish is a protein and loses its toxicity when heated to 60°C [1]. However, the present study showed that ASV was extremely stable over a wide range of temperatures.…”

“…In addition to being a known coral reef destroyer, A. planci is a venomous starfish. Skin injuries due to the crown-of-thorns starfish have been observed and are considered to be a serious medical issue [1,2]. …”

Cytotoxic and apoptotic activities of the plancitoxin I from the venom of crown‐of‐thorns starfish (Acanthaster planci) on A375.S2 cells

“…The accidental sting by venomous crownof-thorns starfish can result in symptoms of illness such as an extremely painful wound, with redness and swelling occurring immediately (Shiomi et al, 1985). The symptoms of nausea and protracted vomiting may also occur (Sato et al, 2008).…”