Six of nine adults who develop Red Sea coral contact dermatitis had seafood allergies. Contact with the "fire" coral was followed by a series of skin eruptions starting with an immediate pruritic urticaria-like lesion which forced the victims out of the water. Within minutes the affected area became erthematous and edematous with eventual blister formation approximately 6 hours after the initial contact. The blisters resolved, leaving violaceous papules and plaques in a streaky fashion corresponding to where the coral brushed the skin. The lesions became shiny and lichenoid in 3 weeks while pruritus persisted. Treatment with topical corticosteroids and oral antihistamines reduced the severity of the disease but did not stop its evolution to the lichenoid stage. Complete resolution usually occurred after 15 weeks, leaving residual hyperpigmented macules.
