Case report. skin injury after contact with a red spine starfish, Protoreaster lincki

Sea stars or starfish (class Asteroidea; phylum Echinodermata) are common in all oceans. The body of the large crown-off-thorns starfish (Acanthaster planci) has numerous calcareous, sharp spines that are covered with epithelial, glandular tissue containing venom (1). Upon contact, the spines easily penetrate the skin, and the proteinaceous venom causes strong pain and local oedema as the main symptoms, followed by nausea and vomiting (2) and possibly anaphylactic shock (3). Surgical curettage with complete removal of the spines and antibiotic treatment is strongly recommended to resolve the symptoms. Here, we report a rare case of skin reaction after contact with a red spine starfish, Protoreaster lincki