Sea Bather’s Eruption: (Sea Lice)

Presentation

Patients seek help because of an intense pruritic or painful eruption of red raised welts, sometimes like mosquito bites. They are at times confluent, appearing in areas that had been covered by swimwear ( Fig. 180.1 ). This will occur within a few hours after bathing in the Caribbean or off the coasts of Mexico, Florida, or Long Island during periods when so-called sea lice are active. Exposed areas of skin are spared. Symptoms may have started as a tingling sensation while in the water, with itching and burning becoming more pronounced if a freshwater shower was taken while still wearing the same suit. Symptoms usually resolve spontaneously in a few days; however, some individuals (especially children) experience a more severe delayed hypersensitivity reaction occurring approximately 10 days after exposure. This rash extends to exposed areas of the body not previously affected, and victims may also experience severe itching, fatigue, fever, chills, nausea, and headache. Outbreaks occur between March and August, with a peak incidence in May.