In the UK, sea urchin-related injuries (SUIs) most commonly present in returning travellers. Delayed complications mainly affect the skin but nerves, tendons, joints and bones may also be involved. The management of chronic reactions may be challenging and a variety of approaches have been described. Surgical measures are often undertaken, particularly when retained spines are suspected. We demonstrate, through three cases presenting in the UK with chronic SUIs, that conservative management, surgery and intralesional corticosteroids may all be associated with satisfactory outcomes. Management options should consider the presence of retained spines, injury site, symptoms and importantly, patient preference.
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