(A) Black sea urchin (Echinometra locunter). (B) The presence of spines in a victim who stepped on the animal.
Reproduced from: Haddad V, Lupi O, Lonza JP, Tyring SK. Tropical dermatology: marine and aquatic dermatology. J Am Acad Dermatol 2009; 61:733. Illustrations used with the permission of Elsevier Inc. All rights reserved.