Get me some ointment, I need an appointment: I got a rash

November 1, 2011 6:34 PM

What is this weird rash on my leg? Pics here

I woke up a couple of mornings ago and noticed an itchiness on my thigh. I felt a bump where the itch is and figured a spider bit me. When I looked in the mirror I was shocked--I've never seen a spider bite (or whatever it is) like this before. Kinda looks like the Lyme disease pattern, but with out the "eye" in the "bull's eye". Anyone know what it is and whether I should go to the doctor?

The colour has gotten a bit more intense since the first day. It's only the slightest bit itchy--moreso a little tingly. I'm located in the Pacific Northwest.

posted by oceanview to health & fitness (51 answers total)

Jesus Christ, I have no idea what that is, but YES go to a doctor!
posted by Madamina at 6:37 PM on November 1, 2011 [4 favorites]

Looks like Lyme disease, honey. Here's a photo of a very advanced case, also missing the bulls-eye usually seen in the center.
posted by R2WeTwo at 6:41 PM on November 1, 2011

That's a get the hell to the doctor rash.
posted by lydhre at 6:42 PM on November 1, 2011 [14 favorites]

Holy cow, please go see a doctor as soon as possible. My immediate thought was lyme disease as well; usually there's a circle of rash in the center, but not always. Either way, go!
posted by phunniemee at 6:42 PM on November 1, 2011

Lyme disease does not always present the white ring. Go straight to an ER, do not pass go, don't worry about money, go directly to the ER, in a cab if you need to.

Lyme disease often causes life altering and irreparable damage when untreated. DON'T FUCK WITH THIS.
posted by Blasdelb at 6:44 PM on November 1, 2011 [7 favorites]

If you give us a city, I'm sure a Mefite will volunteer to drive you if needed.
posted by Blasdelb at 6:45 PM on November 1, 2011 [1 favorite]

What the fuck? I like weird shit and that even freaked me out, GO TO THE ER NOW. If it is Lyme Disease, you need to treated AS SOON AS POSSIBLE. If it is something serious, it needs to BE TREATED NOW. Waiting could mean things that you don't want to face. GO TO THE ER NOW.
posted by MaryDellamorte at 6:46 PM on November 1, 2011

Go to the ER right now.
posted by Threeway Handshake at 6:48 PM on November 1, 2011

It's really classic-looking for the Lyme disease bullseye rash. No need to freak out, but yeah, go see someone as soon as humanly possible. If it is Lyme, you've had it a while, and you need to be on antibiotics as soon as you can in order to prevent long-term effects.
posted by Miko at 6:48 PM on November 1, 2011

I may be crazy, but it just looks like a bruise to me. A multi-colored one, but still a bruise.
posted by cecic at 6:48 PM on November 1, 2011 [2 favorites]

To counter cecic, I am pale, and bruise easily and dramatically, and I've never ever had a bruise in a distinct ring like that. It does not look like a bruise to me, but a spider bite turning bad, or, yes, Lyme's disease.

Nthing the people suggesting you go to the ER tonight. If you're worried about the cost of such a visit, please remember that no amount of money is more important than your health.
posted by artemisia at 6:58 PM on November 1, 2011 [3 favorites]

If you're in the PNW there is a good chance you have Lyme's Disease. My sister got it after hiking in the scrub north of Spokane. You need to get antibiotics in order to hopefully prevent serious problems.
posted by KokuRyu at 6:59 PM on November 1, 2011

I just asked my sister-in-law to look at it and she said it looks like a bruise, and to wait until the doc's office opens tomorrow to get it checked. But, I am definitely not pale, and so artemisia, your comment has me worried.
posted by oceanview at 7:00 PM on November 1, 2011

You don't need to go to the ER, but you should ABSOLUTELY see your doctor first thing tomorrow. It very much looks like Lymes disease OR some kind of bug bite that you are having an extensive reaction to. If it is Lymes, you have around a month from infection to diagnosis (Phase I) to get on antibiotics and not have to worry about a deeper infection.

I had Lymes so I know what I'm talking about -- and no, I don't have any horrible, incurable effects from it. According to this map, it does occur where you live, though it is rare. Have you gone hiking or anything in the past few weeks? Do you live near woods, or near a deer population? Have you recently visited any of the areas on the map where it occurs frequently? Those are important questions that your doctor will need to know.

As far as the rash -- it does not look the same on everyone, and actually (according to my doc) only 60% of people develop a rash. I had 3 rashes develop almost immediately, so I thought I had spider bites, but then a few days or so later, I had a lot more develop all over my body (36 in total).

A big thing here is to go through the other symptoms to see if you're experiencing anything else. Are you fatigued? Achy? Are you experiencing trouble thinking clearly? These are other common symptoms of Lymes.

And if this is Lymes (I'm going with very likely), and you can pinpoint the date that you would have gotten it, that is very important. If it's within the past month, the treatment is generally a heavy course of antibiotics for a month.
posted by DoubleLune at 7:01 PM on November 1, 2011

Never mind sisters-in-law, trained doctors often have a hard time diagnosing Lyme's disease. If you can go tonight, I would do it. The key is getting early antibiotic treatment.
posted by KokuRyu at 7:01 PM on November 1, 2011

I'm like artemisia. I'm very pale and bruise all the time, I have entire life. I've had some ugly bruises yet I've never had a bruise that looked like that.
posted by MaryDellamorte at 7:02 PM on November 1, 2011 [1 favorite]

Hey, I didn't mean to scare you. I'm just saying that if you were my sister or bff, I'd be hauling your ass to the hospital right now, because that ain't normal.
posted by artemisia at 7:07 PM on November 1, 2011 [4 favorites]

"But, I am definitely not pale, and so artemisia, your comment has me worried."

It absolutely should. It does look like it could potentially be a spider bite, but we can't tell you that it is one or not from the internet. The antibiotics to used to treat Lymes are not that expensive, and this is definitely worth the ER's time. Please hop in a car.

Most people who get it these days do fine, but thats only because enough people now know to worry a fuck ton about ticks as well as marks like yours and antibiotics are really effective.
posted by Blasdelb at 7:09 PM on November 1, 2011

On the bruise front:

I'm pale, I bruise easily, I turn all sorts of colors when I bruise, and I'm really clumsy (so I generally have about five forgotten-origin bruises on my person on any given day). I actually have had a bruise that looked like whatever you've got going on with your leg. But let me tell you about that bruise: I remembered it. It hurt like a mofo. There was a huge lump under the bruised area, it was painful to touch (both deep-tissue poking and light grazing with fabric), and it stayed around for weeks, moving through all the predictable bruising colors. But it never itched. It never itched and I was CONSTANTLY aware that the area was bruised. No waking up in the morning, surprised to find a mark; it was ow-ow-ow-ow-ow from the second the injury occurred.

And that is why I don't think what you've got is a bruise. I'm sure your sister-in-law is a lovely person, but unless she has had medical training, I'd scoot on over to an ER, like, yesterday.
posted by phunniemee at 7:10 PM on November 1, 2011 [14 favorites]

Also, your doctor is probably inexperienced with recognizing and treating Lymes, because it isn't prevalent there. This map shows they average about 10 cases per year in the NW states.

I'm going to pass on the general data I got from my doctor, who practices in SE PA and sees dozens of these cases each year.

Blood tests are only somewhat reliable. My doc doesn't usually go that route, because they are expensive and Lymes is so easily diagnosed by sight/symptoms.

When you treat it early with antibiotics, it goes away. You can get bitten again, and get it again, but this is NOT a recurrence - it is a brand-new infection. Lymes is bacteria-based, not viral, so it can be completely killed off.

It is very important to take the full course on antibiotics (even more so than normal) because the symptoms will go away in a few days, but the infection takes longer than that to kill. If you don't take all the antibiotics, it may not get killed off, and then you are left with live bacteria still in your body.

When you go hiking, or just into the woods, wear bug spray, and make sure to apply it to any warm, moist areas (think belly button, toes) because the ticks crawl on you looking for a nice spot to burrow before they bite you.

And I'm just going to repeat to not freak out, unless you have some other drastic symptoms you aren't telling us. If that's all you have, and it turns out to be Lymes, it's probably a very recent infection and waiting 12 hours to see the doctor isn't life-threatening.
posted by DoubleLune at 7:12 PM on November 1, 2011

I immediately thought Lyme disease as well. Add me to the chorus of people suggesting you go to the ER ASAP; better safe than sorry.
posted by constellations at 7:13 PM on November 1, 2011

Get thee to the hospital forthwith.*

* I have had many interesting jobs, but my current one is sourcing images for an online magazine. My next assignment is to source images for a rash guide. In previewing my upcoming work, I recognize anything that looks like what you have is something that a mother would take her child to emergency for, maybe allowing time to change out of pajamas, but there would be no "let's sleep on it" in any case. Now you GIT!
posted by peagood at 7:18 PM on November 1, 2011

I'll be a tiny voice of possible dissent and offer that my wife had a horrific and long lasting bruise that was a weird ring shape and looked just like this (so much like it that I just went to her all worried and made her tell me about it again) and she definitely got it from bumping her hip on the corner of a baby gate. No itching though, normal bruise color changes and tenderness, and it followed directly from one unforgettably excruciating event. We also live in central Los Angeles and haven't been anywhere green in months.

I still think you should get checked out though, my wife's nasty bruise is just one data point and doesn't sound like your story.
posted by crabintheocean at 7:19 PM on November 1, 2011

I think it's some kind of ringworm or fungus.

And, yes, please go to a doctor. It could be blood or something.

People on the internet are not qualified to diagnose this.
posted by frecklefaerie at 7:21 PM on November 1, 2011 [1 favorite]

On my way to a walk-in clinic. Close to me and is open for another hour and a half.
posted by oceanview at 7:23 PM on November 1, 2011 [5 favorites]

Hooray! (And good luck--I really hope everything's OK.)
posted by phunniemee at 7:24 PM on November 1, 2011

Please let us know how you are!
posted by jgirl at 7:25 PM on November 1, 2011

Looks like ringworm to me. Pics.
posted by cocoagirl at 7:28 PM on November 1, 2011

Looks like a pityriasis rosea herald patch. If it is, I sincerely hope that you end up without the itch. I experienced three MONTHS of itchy, torturous hell. May the force be with you.
posted by PorcineWithMe at 7:28 PM on November 1, 2011

Please update us once you get back.
posted by MaryDellamorte at 7:28 PM on November 1, 2011

Neither ringworm nor pityriasis rosea have the nasty purple color OPs rash has.
posted by slow graffiti at 7:46 PM on November 1, 2011 [2 favorites]

Do post follow up. We don't have Lyme here in the PNW, but that's a pretty deeply colored bruise without a trauma history and you need a blood test for a platelet count, hope it's ok.
posted by Slarty Bartfast at 8:33 PM on November 1, 2011

We don't have Lyme here in the PNW

Actually Lyme disease is present in the PNW. My sister caught it hiking in the Cascades, and it is present on Vancouver Island.

The problem is Lyme disease is generally not acknowledged to be here, but it most certainly is.
posted by KokuRyu at 8:39 PM on November 1, 2011

We don't have Lyme here in the PNW

I beg to differ. Just because it's not common, that doesn't make it not exist.
posted by DoubleLune at 8:43 PM on November 1, 2011

It's not *endemic* here. Most cases are thought to come from outside the state.
posted by Slarty Bartfast at 9:05 PM on November 1, 2011

12 confirmed cases in 2010 in Washington state (CDC report). According to the Washington state department of health, 3 cases that were reasonably thought to possibly originate from tick bites in Washington state. Your sister is incredibly unlucky.
posted by Slarty Bartfast at 9:11 PM on November 1, 2011

OK, I'm already back. I went to 2 walk-in clinics close to me to get more than 1 opinion.

Both docs said it was a bruise.

Doc #1:
-Closely inspected it
-"It's a bruise, not a bite"
-"Did you sit on a rock or a pebble?"
-"I don't see a bite mark"
-When i suggested Lyme disease, he quickly dismissed it
-"Should be gone in a few days"

Doc #2:
-Didn't look very closely; quickly surmised that it's just a bruise.
-He figures I must have hit my thigh on something, but it wasn't painful enough to register. A blood vessel broke and now the blood is pooling to create the bruise.
-Should be gone within a few days, but said to come back if still worried
-One of those doctors that wears a jokey tie
posted by oceanview at 9:18 PM on November 1, 2011

I guess that's reassuring, do you have a trusted regular doc you can go to tomorrow? Memail if you're in Seattle.
posted by Slarty Bartfast at 9:22 PM on November 1, 2011

I was at a drunken, blurry Halloween party on Friday. Maybe something happened that night which I was too drunk to remember or feel.

If it doesn't get better in a few days, I'll see my regular doc.

Thank you all for your suggestions and concerns :)
posted by oceanview at 9:26 PM on November 1, 2011

Drunken blurry Halloween party totally counts for a trauma history :)

But I'm Seconding Slarty Bartfast's suggestion, that does make for an awfully weird bruise. The mark started to show up Saturday morning, like would make sense for some kind of leg smacking Friday, right?

Thanks for the update!
posted by Blasdelb at 9:37 PM on November 1, 2011 [1 favorite]

IANYD but I agree with your walk-in doctor opinions - Lyme disease 'bulls eye rash' is also known as 'erythema migrans' called as such because it is pink/red in color (aside from it being a lot less likely in your area of the country). Your mark is purple rather than red (like a bruise). Agreed it is an odd bruise because of the shape of it. I would think you would remember an injury causing something like this. You're not sleepwalking or anything, right? :-)
posted by treehorn+bunny at 10:04 PM on November 1, 2011

I have in fact seen a bruise just like that. That is a giant version of the bruise my friend got when she wiped out on her bike and stabbed herself in the chest with her unplugged bar-end. If you thumped your leg into something like an exposed bit of pipe at the drunken Hallowe'en party, you could totally get a freaky annular bruise. (I can't even tell what part of your leg that is from the pictures, which is why I didn't play the what-is-it game.)
posted by gingerest at 11:36 PM on November 1, 2011

I looked at your pictures and thought "Uhh, isn't a bruise, not a rash?" It looks purplish on the outside and kind of yellowish on the inside, from what I can tell in the pictures, and that is classic bruise coloring for me.

I get bruises like that not terribly infrequently, and when they get into the healing stage they can get a little itchy. I would guess you smacked into a nice coffee-table corner.
posted by that girl at 2:51 AM on November 2, 2011

IANAD either but I had Lyme disease, and my rash was not pink, but a dusky purplish gray. the first time I went to the doctor, with just the bite, he pooh-poohed it and sent me home with no treatment. Three days later the rash had bloomed further, I developed fever and chills, and I went back, and walked out on doxycycline.

OP, It was great to get two doctors to look and the bruise sounds reasonable; I'd just say to keep an eye on it, and also the rest of your general physical health.

But in the case of anyone else searching about a mysterious bruise, I wanted to be sure to add that Lyme disease is famous for presenting really variably:

[Lyme] EM rashes can be uniform in color, oozing, blistered, scaly, and in a variety of shapes. They can range from a pink color to shades of deep red, purple, or brown.

So just because it doesn't look like what you heard about a Lyme disease rash doesn't mean it's not one of the many ways Lyme can manifest. Only about 1 in 10 of Lyme rashes take the classic pattern. In many cases there's no bruise at all. Unexplained, itchy bruises should definitely be checked out.
posted by Miko at 5:27 AM on November 2, 2011 [1 favorite]

Yes, please study up on the symptoms of Lymes and keep an eye out for ANY other symptoms. And keep in mind that not all people who get infected get these symptoms. I hope it is just a bruise, but a doctor wouldn't be able to see a bite from a deer tick -- they are just too small. I still recommend going to your regular doctor -- Lymes is rare enough in your area that I would want the opinion of an MD I trust from experience in your case.
posted by DoubleLune at 6:43 AM on November 2, 2011

Awesome! I'm glad you went and got it settled and the diagnosis was totally benign. I'm glad you're planning to keep an eye on it, too...
posted by artemisia at 6:54 AM on November 2, 2011

Sounds like you already have it resolved, but just for the record it looks totally like the bruises I get from smashing my calve into the crank hub on my mountain bike.
posted by Pink Fuzzy Bunny at 10:34 AM on November 2, 2011

For all those people who say they've never seen a ring-around-the-bruise before... I have. Wish I hadn't, but I have. Here's my leg after crashing during a motorcycle trail ride; it got more colorful a few days later. I think you should still get a third opinion from a doctor with a serious tie, but ringed bruises can happen.

OMG this hurt so much; it became a hematoma that could bring me to tears when it jiggled. I walked veeerrry carefully for a long time after this. You should consider the possibility that you were shithammered on Friday, to not remember what caused this.
posted by workerant at 11:15 AM on November 2, 2011

Please keep a really close eye on it. I see that you have gone to the doctor and had it identified (twice!) as a bruise. Phew!!!

Because not to scare the crap out of you, but that looks a lot like the earliest stages of a hobo spider bite. The next stage is necrotizing tissue, where basically it all starts to turn black and dissolve from the inside out, with attendant risk of blood infection, loss of limb, etc.

This is what happened to a coworker's husband (here in the Pacific Northwest also). He nearly died. He's lucky they were able to save his leg, but he will walk with a cane for the rest of his life.

If you start running a fever, or if it does anything other than start to fade, please go straight to the ER! It could literally save your limb.
posted by ErikaB at 11:55 AM on November 2, 2011

Man, I wish I would have seen this last night. I would have added another voice to the "it looks like just a bad bruise" chorus. I had a bruise just like that a month or so ago...still have it, sort of. Even though the bright colors are gone I can still feel the bump under the center yellowish part.

I never thought that it was Lyme's Disease because I remember getting the bruise. I ran into an end table in front of a room full of people and almost wet myself from the pain. It hurt like a motherfrakker.

Ow, I pressed on it lightly and it still hurts. I hope yours heals faster than mine.
posted by Elly Vortex at 12:09 PM on November 2, 2011

The bf was diagnosed with Lyme disease a few weeks ago - it first presented as a big vaguely circular rash (of little red bumps) on his leg, which I misidentified as ringworm. After that (about 5 or 6 days) it got the black and blue bruise-y look, but it still had sort of rashy bumps involved around the perimeter. Thankfully at that point we realized he needed a doc visit asap.

Anyway! If you haven't seen any rashy bumps or whatnot, and it does indeed go away in a couple of days, you're probably fine. But it's always good to check, especially if you've had any instances of generalized joint pain / etc.
posted by Cimrmanova at 3:14 PM on November 2, 2011