What kind of rash is this?

This 38 year old male presented to me on Monday, November 24, 2008, with a chief complaint of an oval shaped rash on the inside of his right leg, just above the ankle. He discovered it on the evening of Sunday, November 23, 2008, because of symptoms of itching and pain. At the time of discovery it was the size of the dark red area in the photo below. Since then the rash has expanded concentrically into an area that shows lesser degrees of inflammation and which measures 5 x 3.5 inches. In the twelve hours preceding the first office visit the central area has become darker. The central part of the rash is warm to the touch. He experiences discomfort when walking. There are no other significant systemic signs or symptoms.

On Saturday, November 22, 2008, he spent some time in a neighborhood park and at a football game, but there is no history of insect bites.

Have you seen a rash like this before? If so, do you know what may have caused it? What kind of treatment would you recommend?

Rash above the ankle, on inside of right leg.

drbloem Says:

November 26, 2008 at 11:15 am

Here is a responses from one of my colleagues who practices NeuroModulation Technique (www.nmt.md) and acupuncture:

“That looks like a rash my brother-in-law had in September.
He and his MD thought it was a spider bite.
Lyme titer was fine … to start.
He coincidentally started to have pain and weakness in his arms which spread to legs.
MRI’s of spine were negative.
By the time his 2nd Lyme came back, about 2 weeks after the first, it was “off the charts”. He had already started with the Bell’s Palsy.
I believe he was on Doxycycline or Tetracycline for 10 days.
He doesn’t really believe in NMT, but I did that and acupuncture. He resolved the Bell’s Palsy in less than a week. Has been pain and symptom free since my one treatment in Sept.
Was it AB tx.? NMT? Acu? Don’t know. But he is less skeptical.”

Bronwyn Says:

November 26, 2008 at 6:53 pm

I have seen recluse spider bites that look like this.

November 27, 2008 at 8:49 pm

Another colleague who practices NeuroModulation Technique had the following comments:

“I’ll go with the general insect consensus – in fact, it’s remarkably similar to a spider bite I received in the summer. I didn’t actually feel the bite, but narrowed it down to that from research (the redness and rash wasn’t there when I sat down to work a few hours before, and I had felt nothing painful during that time period). What came up for me was the toxin pathway – repeatedly for weeks – and ISRP a few times, with a bit of emotional work thrown in (bit of remaining fear of spiders I haven’t taken the time to clear).

I have to admit that I’ve jumped on the ‘don’t worry about why’ bandwagon and go straight for the MRT on priority for correction. Whether it’s a tick, spider, or what have you, the ACS will let you know the best way to deal with the rash….and I’m likely ‘preaching to the choir’ about that, aren’t I? 🙂 Since he was out ‘playing’ in the park, I’d check on OHI inclusions or ASTs for ‘not being allowed to have fun’ or ‘having fun will come back and bite you’ or such things as well….

Can’t wait to hear about your results!”

Another comment from a colleague who practices NeuroModulation Technique:

“My son used to get that.

It looked to me like it was probably a spider mite type of bites or perhaps another insect. He used to get it really bad and the whole leg would become discolored and swollen for a number of days. At the time I only knew NAET, I treated him with NAET and gave him homeopathic remedy, Apis. That took care of it. Even if he had it again there after, it never got any worse than just the initial bite.”

Elaine Says:

January 6, 2010 at 2:15 am

I am not a doctor or health practitioner but I am very lyme literate. My first reaction to the picture of red area was that it looked like Lyme. I have also gotten spider bites that looked similar but they also got swollen and hard and eventually resolved.

Kitty Says:

September 2, 2010 at 1:12 pm

I have been getting these type of bites all Summer. I’m used to getting bites -bugs and things seem to love my skin!

But now I’m getting these types of weird bites quite a bit, and each time they are getting bigger and more swollen.. does anyone know why this would be, why the more I get the bigger they are getting?

I never see whatever is biting me, and at first it’s just a hard, yellow swelling. Within a couple of days they go dark red/ purple/ and partly black in places. They are gone in about 1-2 weeks. They look similar to the picture above.

I currently have a very large one on my leg. The rash around it is growing, and now covering half my leg. The skin feels tight and very strange.

Would love if anyone has any suggestions to how I can prevent from getting these, or what is biting me!

Becca Says:

July 22, 2011 at 1:42 pm

I have subcutaneous vasculitis in my lower legs & when I get a mosquito bite, it forms a welt/rash just like the one in the picture. I have pictures

Roxanne Berg Says:

September 25, 2011 at 4:27 am

I had cellulitis on the front of my lower leg. It looked exactly like the rash in the picture. I had no broken skin.
But as I was in the grocery store, pushing the cart, a 2 liter pop bottle slipped through one of the front holes in the cart for children’s legs and hit the front of my leg quite hard.
4 years later, I still have a slight bruise from it. There was swelling and the red area grew quite large. Probably 5″ across.
My doctor was quite puzzled. But antibiotics took care of it.
The cellulitus took a while to develop. The pain and slight bruise I had received from the initial injury was gone by the time the rash and swelling set in.
I’m not doubting the fact that this man was bitten by a bug. But, it just goes to show you how many similarities there can be.

Laura Says:

April 17, 2016 at 6:54 pm
I know this thread is old. But i am wondering about your cellulitis! I have a nasty patch of it on my lower leg (im guessing like yours started with a bruise!) I have pictures if you want to see if it looks like yours did. I am concerned because ive been on bactrim for 10 days and it seems to not be working at all. The longer im sitting or on my feet, the more purple it gets… 😦

naomi Says:

July 23, 2012 at 3:04 am

i was recently bitten 36 times on my legs by mosquitos and i looked like i had been beaten with a baseball bat, each bite swelled and looked like huge bruises, my ankle and foot swelled and it hurt to walk, i could feel the fluid in my foot wobbling every step. i have been bitten 5 times again 4 weeks after last time and thay have done the same thing, but it looks terrible as i have still got discolouration from all the last ones. i’m certainly not putting shorts on this summer.

Dak Chase Says:

September 20, 2012 at 10:50 am

its not a spider bite – i get it every year because of the heat – it has something to do with the heat – it not only itches and get red, it burns – also hurts to stand or walk it seems to tighten up the skin and area effected – kind of like your skin there is normal and flexible to move – then when this happens it it get tight and hard like a rock from the inside

Dak Chase Says:

September 20, 2012 at 10:53 am
its NOT a spider bite i have this condition as im typing it right now – i get this every year from the heat

1. Dak Chase Says:
  
  October 13, 2012 at 2:57 pm
  also i still have it, it takes weeks to go away AND its on BOTH legs – also it burns from the inside out and the outside of my legs has peeling like you get from a sunburn. this is NOT from a spider bite whatsoever!