Editing Brown recluse spider (section)

====Specific treatments====
In presumed cases of recluse bites, [[dapsone]] is often used for the treatment of necrosis, but controlled clinical trials have yet to demonstrate efficacy.<ref>
{{cite journal
 | last1 = Elston | first1 = D.M.     | last2 = Miller  | first2 = S.D.
 | last3 = Young  | first3 = R.J.     | last4 = Eggers  | first4 = J.
 | last5 = McGlasson | first5 = D.    | last6 = Schmidt | first6 = W.H.
 | last7 = Bush   | first7 = A.
 | year = 2005
 | title = Comparison of colchicine, dapsone, triamcinolone, and diphenhydramine therapy for the treatment of brown recluse spider envenomation: A double-blind, controlled study in a rabbit model
 | journal = [[Archives of Dermatology]]
 | volume = 141  | issue = 5  | pages = 595–597
 | doi=10.1001/archderm.141.5.595  | pmid=15897381
}}
</ref>
However, dapsone may be effective in treating many "spider bites" because many such cases are actually misdiagnosed microbial infections.<ref name=AnnEmergMed2002-Vetter>
{{cite journal
 | vauthors = Vetter R, Bush S
 | year = 2002
 | title = The diagnosis of brown recluse spider bite is overused for dermonecrotic wounds of uncertain etiology
 | journal = [[Annals of Emergency Medicine]]
 | volume = 39 | issue = 5 | pages = 544–546
 | pmid = 11973562 | doi = 10.1067/mem.2002.123594
}}
</ref>
There have been conflicting reports about its efficacy in treating brown recluse bites, and some have suggested it should no longer be used routinely, if at all.<ref name=AmJEmergMed2003-Bryant>
{{cite journal
 | vauthors = Bryant S, Pittman L
 | year = 2003
 | title = Dapsone use in ''Loxosceles reclusa'' envenomation: is there an indication?
 | journal = [[American Journal of Emergency Medicine]]
 | volume = 21  | issue = 1  | pages = 89–90
 | pmid = 12563594  | doi = 10.1053/ajem.2003.50021
}}
</ref>

Wound infection is rare. Antibiotics are not recommended unless there is a credible diagnosis of infection.<ref name=MoMed1998-Anderson>
{{cite journal
 | last = Anderson | first = P.
 | year = 1998
 | title = Missouri brown recluse spider: A review and update
 | journal = Missouri Medicine
 | volume = 95 | issue = 7 | pages = 318–322
 | pmid = 9666677
}}
</ref>

Studies have shown that surgical intervention is ineffective and may worsen outcomes. Excision may delay wound healing, cause [[abscesses]], and lead to scarring.<ref name=AnnSurg1985-Rees>
{{cite journal
 | vauthors = Rees R, Altenbern D, Lynch J, King L
 | year = 1985
 | title = Brown recluse spider bites: A comparison of early surgical excision versus dapsone and delayed surgical excision
 | journal = [[Annals of Surgery]]
 | volume = 202 | issue = 5 | pages = 659–663
 | pmid = 4051613 | pmc = 1250983
 | doi = 10.1097/00000658-198511000-00020
}}
</ref>

Purportedly application of [[Glyceryl trinitrate (pharmacology)|nitroglycerin]] stopped necrosis.<ref>
{{cite web
 |last=Burton |first=K.
 |year=2021
 |title=The brown recluse spider: Finally stopped in its tracks
 |series=Yosemite forest
 |website=geocities.com
 |url=http://www.geocities.com/Yosemite/Forest/2021/recluse/intro.html
 |access-date=September 2, 2006
 |archive-url=https://web.archive.org/web/20060420183312/http://www.geocities.com/Yosemite/Forest/2021/recluse/intro.html
 |archive-date=April 20, 2006
}}
</ref> However, one scientific animal study found no benefit in preventing necrosis, with the study's results showing it increased inflammation and caused symptoms of [[Loxoscelism|systemic envenoming]]. The authors concluded the results of the study did not support the use of topical nitroglycerin in brown recluse envenoming. <!--
Are there medical experiments with leeches? Yes, there are many, they're even used in surgery sometimes, but not specifically recorded in cases of brown recluse evenoming.
--><ref name=AnnEmergMed2001-Lowry>
{{cite journal
 | vauthors = Lowry B, Bradfield J, Carroll R, Brewer K, Meggs W
 | year = 2001
 | title = A controlled trial of topical nitroglycerin in a New Zealand white rabbit model of brown recluse spider envenomation
 | journal = Annals of Emergency Medicine
 | volume = 37 | issue = 2 | pages = 161–165
 | pmid = 11174233  | doi = 10.1067/mem.2001.113031
}}
</ref>

Antivenom is available in South America for the venom of related species of recluse spiders. However, the bites, often being painless, usually do not present symptoms until 24 or more hours after the event, possibly limiting the effect of this intervention.<ref name=ClinTox2003-Isbister>
{{cite journal
 | vauthors = Isbister G, Graudins A, White J, Warrell D
 | year = 2003
 | title = Antivenom treatment in arachnidism
 | journal = Journal of Toxicology: Clinical Toxicology
 | volume = 41  | issue = 3  | pages = 291–300
 | pmid = 12807312  | s2cid = 37946164
 | doi = 10.1081/CLT-120021114
}}
</ref>