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A 7-year-old male patient from Bonito (Mato Grosso do Sul State, Brazil) presented “dark spots" on his foot without previous manifestation (Figure A). Frightened by the tonality of the lesions, his mother sought medical care. The lesions disappeared after two months. Skin lesions caused by Diplopoda or millipedes (“piolhosde-cobra”, embuás, gongolôs) are relatively common and occur when these myriapods penetrate the shoes and are compressed or crushed1,2. At this time, they release toxic substances, such as alkaloids and hydrogen cyanide, which cause moderate initial inflammation and long lasting hyperchromic pigmentation. This can lead to complex differential diagnoses, especially when located in the extremities of the elderly and diabetics, as they simulate arterial ischemia and necrosis. The macules of the patients are anomalous and the circular and concentric aspect reproduces the body shape of the animal curled up and justifies the publication3.

An unusual dark macular lesion in the plantar region of a child