Loxoscelism (bites by spiders of the genus Loxosceles) is the only proven arachnological cause of dermonecrosis. Although Loxosceles spiders can be found worldwide, their distribution is heavily concentrated in the Western Hemisphere, particularly the tropical urban regions of South America. Although Loxosceles bites are usually mild, they may ulcerate or cause more severe, systemic reactions. These injuries mostly are due to sphingomyelinase D in the spider venom. There is no proven effective therapy for Loxosceles bites, although many therapies are reported in the literature.