Dermatomyositis induced by the secretion of Phyllomedusa bicolor or Kambô frog - A case report.

The Amazonian Kambô frog, Phyllomedusa bicolor, is commonly known for the potential benefits of its secretion. The Kambô ritual consists in applying the toxin directly to a freshly burnt skin area, since it is believed by natives and shamans to purify and strengthen the body and mind of the user. We describe a 33-year old female with a history of periodic use of Kambô toxin who presented with a 3-week course of asthenia, malaise, myalgia, and proximal muscle weakness predominantly in the lower limbs. She had elevated muscle enzymes and an abnormal electromyography. We used the 2017 European League Against Rheumatism and American College of Rheumatology classification criteria to establish the diagnosis of dermatomyositis. The patient demonstrated clinical response to prednisone, with a complete recovery of signs and symptoms after 8 weeks of treatment. To our knowledge, this is the first case report of dermatomyositis possibly associated with the use of Kambô. The Kambô cleansing ritual is becoming popular in first world countries, but its use may lead to serious side-effects, sometimes life-threatening. In patients presenting with signs and symptoms suggestive of dermatomyositis and a skin line of circle-shaped burns, Phyllomedusa bicolor skin secretion exposure should be suspected.