The afternoon of my little mishap I was tearing down a well established (22 years) tank with the main rock a piece of pumice that I had siliconed in place due to the fact that it floats! It was completely covered in "Texas Trash" green palys. Although they were pretty in their own way, I had no intention of moving them into my newly set up 120DT. My arm brushed against them many times while trying to catch the fish. At one point, I could start to feel something akin to a sunburn on my arm. Then it clicked. I looked at
my wife and told her that if I were to lose consciousness she was to call 911 and tell them it was palytoxin poisoning. She, of course, looked at me like I had 3 heads. Then I explained it to her. It didn't get any worse so we went to dinner like normal, although the burning intensified somewhat. In the middle of the night the pain woke me up several times. I just kept thinking "Well, at least I'm ALIVE!" In the morning I got up and looked at my arm. The blisters were way worse than in the picture so off to the UC I went. The triage nurse asked what the problem was and when I told her "palytoxin exposure" she had a blank look on her face so I took off my jacket. And was then escorted straight back to an exam room where the Doctor came in immediately. I told him the problem. He called Poison Control on speaker. They asked if I was alive. I assured them that I was. Steroids and pain meds was about all they could do at that point. Went to my PCP the next day where he decided to sent a sample off for cultures to r/o infection. To prevent it from becoming contaminated, he used a #11 scalpel and NO lidocaine. His nurse held my arm still, but really, it didn't hurt as much as the blisters themselves did.
I work in an OR, so obviously scrubbing in was not going happen until things healed up enough.
FWIW - that whole rock got well wrapped and sent to the dump. I also have a pair of extra long gloves I can wear if there is any question about things like this in the future.
Just my experience - your mileage may vary.