Identifying and misidentifying the brown recluse spider.

The brown recluse spider, Loxosceles reclusa, is often implicated as a cause of necrotic skin lesions.[1-3] Diagnoses are most commonly made by clinical appearance and infrequently is a spider seen, captured or identified at the time of the bite.[1, 2, 4-6] The brown recluse lives in a circumscribed area of the U.S. (the south central Midwest) with a few less common recluse species living in the more sparsely-populated southwest U.S.[7] In these areas, where spider populations may be dense, recluse spiders may be a cause of significant morbidity. However, outside the natural range of these recluse species, the conviction that they are the etiological agents behind necrotic lesions of unknown origin is widespread, and most often erroneous. In some states such as California, unsubstantiated reports concerning recluse spider bites have taken on the status of "urban legend" leading to overdiagnosis and, therefore, inappropriate treatment.