SAP Multidisciplinary Open
Exogenous pigmentation of the toes due to exposure to millipede toxins
By Carlos Alberto Paz-Román, Jaques Sztajnbok, Ronald Yana Herrera and 5 others.
Abstract
Introduction
Exogenous pigmentation resulting from contact with diplopods (millipedes) is an uncommon dermatosis that can mimic ischemia, necrosis, or melanoma. Benzoquinones react with keratin to produce dark, self-limiting pigmentation.
Case report
A 3-year-old pediatric patient presented after stepping on an arthropod identified as a millipede. The patient experienced discomfort, and 6–8 hours later, dark pigmentation appeared on the foot and toes. Pulses, capillary refill (under 2 seconds), sensation, and temperature remained normal, with no inflammation or systemic involvement. Management consisted of washing the feet and observation, with the pigmentation clearing within 48–72 hours.