To the Editor.
—The article by Edwards et al entitled "Loxoscelism of the Eyelids" in the November Archives (1980;98:1997-2000) has the following flaws, in my opinion.
I do not believe the author can demonstrate that this necrosis of the eyelids was due to loxoscelism at all. The spider was not recovered to be identified by an expert, nor were findings from specific immunologic studies presented. The editors of the principal scientific journal concerned with studies of venoms, Toxicon, have repeatedly protested the publication of cases of envenomation of humans in which no evidence of the source of the venom can be given.
Considering only cases of proved loxoscelism, no similar pattern of spread of venom away from the site of the bite is known. In the human dermis, the venom is rapidly fixed to blood vessels, and so, almost always, necrosis at the original site is rapid and
Anderson PC. Loxoscelism of the Eyelids. Arch Ophthalmol. 1981;99(5):908. doi:10.1001/archopht.1981.03930010908025