You are not my doctor. Please hit me up with anecdata.
February 20, 2015 3:33 PM   Subscribe

On my right wrist and the back of the same hand, I have a patch of red inflamed skin roughly the same size as a round cotton wool pad. I woke up with it (about 16 hours ago). Earlier this evening I drew around it with a marker to see whether it would spread further, and I think it has a tiny bit.

Normally, I'd assume this was just a red rash of some kind. The complication is that 2-3 weeks ago, I got a cat bite on that same hand (not in the same place), which became infected and which was treated with a week of Co-amoxiclav.

This rash isn't hot or painful. It's the same temperature as the rest of my skin. It's itchy now, but that's only been for a little while. I feel fine, in fact I just got over a really nasty cold and feel better than I have for the past week.

I have a packed schedule this weekend and would prefer to avoid the disruption of visiting a doctor if I can. If I call 111 they will probably tell me to go in even if it's unnecessary - when I saw the doctor about the cat bite he said they'd been really alarmist, not that I didn't need to be seen right away.

Another complication is that the house was treated a couple of days ago because of a bedbug. Literally, one bedbug (according to the exterminator), but this bedbug left large weals in seven places on my neck as a result. OTOH none of them are as large as this red rash. Whatever this is, I don't think it's a bedbug bite. I guess I could have come into contact with the insecticide, since I sleep on the floor.

Obviously I'll go to the doctor if something sinister happens. But what if something sinister has already happened and I'm not being alarmist enough? This is where my question comes in.

Have you had an experience like this one? If so, do you want to give me grim warnings like "I ignored a rash like yours, and two hours later I was dead! The wifi connectivity in the hereafter totally sucks!" Or "my brother ignored a rash like yours, and now he doesn't have the use of that hand!"

I am not mistaking the hivemind for a doctor and I will not cast blame on anyone who guesses wrong. I am not going to sit here watching my arm turn black and fall off and go "well, how was I to know this was a bad thing, because nobody on MeFi said!" I just want to know if anyone else has experienced this under similar circumstances, and if so, do you have any dire warnings?
posted by tel3path to Health & Fitness (17 answers total)
 
Is the skin bumpy or swollen at all?
posted by bunderful at 4:14 PM on February 20, 2015


Can you show us a picture?
posted by gudrun at 4:20 PM on February 20, 2015


My expertise here is 21 years of battling excema and sensitive skin.
If the itching is bothering you can take an oral antihistamine (like bennedryl) or use a hydrocortisone or antihistamine ointment/cream. You can also run it under hot (but not scalding) water to release histamines, just be sure to follow up with a non-irritating moisturizer.
I would recommend posting a picture, too, if you can. Personally I would not waste a co-pay on seeing a doctor yet. Particularly if it's not a specialist/dermatologist, you may just get "uhhhh contact dermatitis? here's some higher strength hydrocortisone". It sounds like you're doing a good job monitoring it for heat, weeping, and pain. While you're at it, it may help to take a photo of it every so often, to either convince yourself its not worsening or to show your doctor its progression if you do seek care.
posted by rubster at 4:34 PM on February 20, 2015 [1 favorite]


if it keeps getting bigger, or if you get more patches and it's really itchy, it could be ringworm (which is actually a fungus, easily treatable but it will itch like hell until you get it treated)
posted by nakedmolerats at 5:08 PM on February 20, 2015


I am absolutely not a doctor. But a doctor once told me, when I called in about a weird skin thing on my child, "Bad things get worse." IOW, if it was staying relatively stable in a 24 hour time frame, it was probably OK to wait and see. With what you've described, I'd definitely feel comfortable just keeping an eye on it and not moving to immediate treatment unless it started to change pretty quickly -- like if it gets WAY outside the line in the next 6-12 hours, or if it starts to hurt or get hot, or if it gets black in the middle, or whatnot.
posted by KathrynT at 6:45 PM on February 20, 2015


do you wear a watch?
posted by docpops at 9:07 PM on February 20, 2015


I had something similar that swelled up over two weeks to look like I had a golf ball half buried in my wrist, and which made it difficult for me to bend my wrist or wear my clothes due to excessive tenderness. The cause was probably a cut from banging the table or a scratch from my friend's pet rat, followed by subsequent infection. The solution was to see a doctor who cut it open and applied disinfectant.

If it starts hurting more and getting bigger, good idea to get it checked out.
posted by appleses at 10:39 PM on February 20, 2015


Are you still on the Co-amoxiclav? Because it sounds like it could be a drug rash, and antibiotics are a common source of such rashes. They don't tend to look like weals, though, more like this. If it's a raised weal I'd suspect the bedbug.
posted by kisch mokusch at 2:45 AM on February 21, 2015


Thanks everyone. If you are reading this, it means that I am dead... no, wait, that's not it.

The rash started to lessen as soon as I posted this question, and possibly as a direct result of posting this question. It's spread over a slightly wider area, but it's also faded an awful lot from how it was yesterday. I'm satisfied that it's probably just a superficial skin irritation.

FYI, when the cat bite got infected, I called the doctor to make an appointment and the receptionists were like ZOMG ur at DEATH'S DOOR you must go to the emergency room within the next HOUR or all is lost!!!!1!!!! Well I didn't feel at death's door, and it took me longer than that to get home, and then I dialled 111 and they said the same thing. I didn't feel at death's door, but I went to the emergency room anyway, and the doctor grumbled about them being alarmist and I wasn't at death's door exactly, just waiting in the hallway for death's receptionist to give me a questionnaire. But that nevertheless it couldn't wait till morning to treat and I must go to a 24-hour pharmacy for my prescription and I should have come in as soon as I got bitten.

So that's why I posted such a seemingly over-cautious question about this rash. Whatever it is, though, I'm pretty sure it's coincidence.
posted by tel3path at 2:49 AM on February 21, 2015


Oh and I finished the antibiotics a couple of weeks ago, so that can't be it.

It's not looking or acting like a bedbug bite, otherwise I would be searching my room with a very tiny gun right now. I hate that little fucker.

I don't wear a watch.

It started as a relatively well defined patch of red, as if I'd slept on my wrist funny. No punctures. No mottling or texturing, just plain red/pink. Then plain, slightly swollen red/pink. Now pink and less defined and less swollen. It looked a lot like pictures of cellulitis yesterday, just not as bad.

Is mystery!
posted by tel3path at 2:55 AM on February 21, 2015


Do you live somewhere that's cold/dry right now? In the winter I get random red, itchy patches sometimes if I've had to wait out in the cold or it's been really windy, etc. Maybe since that skin area was already kinda on-edge from the cat bite, something that normally wouldn't have bothered it (cold, scratchy tag on a pillowcase, something like that) set it off.
posted by augustimagination at 9:25 AM on February 21, 2015


Sounds like some sort of contact dermatitis. You probably just rubbed up against something you're mildly reactive to.

If it were me, I would wash and thoroughly rinse the spot and put some hydrocortisone cream on it. I wouldn't worry about it unless it got a lot worse or was there for several days without improvement. Skin sometimes just gets irritated like that.
posted by Jacqueline at 10:36 AM on February 21, 2015 [1 favorite]


Except if it is cellulitis or some sort of fungal infection, applying hydrocortisone could make it worse, not better.

Am glad to hear it's subsiding.
posted by kisch mokusch at 3:02 PM on February 21, 2015


Have you had an experience like this one?

Yes - it turned out to be cholinergic urticaria (heat hives) - and no dire warnings, antihistamine clears it up pretty completely.
posted by capricorn at 10:22 PM on February 21, 2015


IAAD, IANYD...

The fact that it's two weeks out is reassuring about infection and I tend to agree that it is probably some kind of hypersensitivity reaction (a contact, possibly a foreign body under the skin). As far as infection goes, you are not going to do any major harm putting hydrocortisone on it and seeing how it does.

That having been said...do NOT fuck around with hand infections and do NOT fuck around with cat bites and especially do NOT fuck around with cat bites on the hand. The doctor who left you with the impression that going in was being "alarmist" was wrong wrong wrong. All cat bites need prophylaxis and need it basically as soon as you've finished washing it out with about 20 liters of clean water. Amoxicillin/clavulonate is the right drug, typically 5 days. My anecdata is that all untreated cat bites on the hand pus out and end up needing drainage and IV antibiotics. I'm sure there are people who say that Fluffy bites them all the time and they never have a problem but depending on the depth of the bite and how well it's cleaned, the location, and the patient's underlying health, the rate of infection in unprophylaxed bites may be upwards of 30% and even with appropriate prophylaxis, the subsequent infection rate may be as high as 15%. On top of that, you need a tetanus shot, so there is abundant reason to seek urgent medical attention after a cat bite. The current guideline from the Infectious Disease Society of America calls for immediate irrigation with sterile water or saline, 3-5 days of amox+clav, a tetanus booster, and close clinical follow up within days of the initial evaluation.

So yeah, my vote is that the odds are in your favor that this is nothing, but the risk is great enough to not tolerate "good odds" and this warrants a check up with your doctor.
posted by Slarty Bartfast at 12:07 AM on February 22, 2015


Slarty, thanks for your concern. The rash is almost gone now. I showed it to a pharmacist yesterday, and she was visibly rather scornful that I would even ask.

I've had all my tetanus shots (literally, all of them) and the emergency doctor did ask about them.

We've had only one previous occasion in the family when a cat bite broke the skin. It was my elderly mother who got the bite, and it didn't get infected. Not that that changes anything, of course, I just thought it would be okay to wait and see. I won't wait and see next time.
posted by tel3path at 2:51 PM on February 22, 2015


In case anyone's still reading this, now that the inflammation has almost disappeared, I can see two red pinpricks about 3mm apart that I couldn't see before. I'm wondering if this is a spider bite, maybe?

If so, this is an announcement for any and all creatures with teeth: STOP BITING ME. I AM NOT TASTY OR NUTRITIOUS.
posted by tel3path at 6:51 AM on February 26, 2015


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