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Vakul Aren
Vakul Aren, Doctor
Category: Health
Satisfied Customers: 3565
Experience:  MBBS,DTM&H( Univ of Liverpool),34yrs experience in practice
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I became aware of an odd itch feeling on my right upper arm..red dot

Resolved Question:

During my morning routine this morning I became aware of an odd itch feeling on my right upper arm. I chose to look before I scratched due to the odd feeling. It was a perfect red dot the size of men's shirt button. It was raised slightly, oozed a tiny bit on the side, uniform in color, tender, and with maybe 4 tiny bumps on top. I took a benedryl immediately. My temp was slightly elevated to almost 100*. Within a couple of hours, there was redness spreading out from the raised circular area. At this time, the original circular area looks more raised with the top skin looking as if the top layer of skin has disappeared and the under layer of more raw skin is there now. The area around the circular spot has become more itchy and swollen without any pattern, no signs of additional open circular sores. The area that has become itchy is the size of a fist. So, the picture is: big, very red, perfectly circular open sore the size of a shirt button, tiny bit of ooze, maybe 4 small bumps inside, open layer of skin, itchy, burning, tender; lighter red area around the circular sore that itches with the skin tender and sensitive to touch, slightly raised; an area around all of this that itches, but has no rash. I took Benedryl earlier. The increased itch may be the Benedryl wearing off.?. Slight small fever, just at or under 100*. This is located about 4" above my right elbow on my inner arm. I don't smoke, but looks abit like a cigarette burn with a larger circle area. What are your opinions?
Submitted: 6 years ago.
Category: Health
Expert:  Vakul Aren replied 6 years ago.
Dear Customer,
Welcome to Just Answer.The cause of a sudden itchy lesion wuld be secondary to acute allergy.This may be secondary to a insect bite,Contact Dermatitis,Drug reaction,Atopic Dermatitis,reaction to soaps and cosmetics or Idiopathic.Pemphigoid or Bullous Pemphigoid disease and autoimmune diseases need to be ruled out.The fever ,increased itching could be due to the inflammation secondary to the allergic reaction.Use of nonsedating antihistaminics like Fexofenadine(allegra)/cetrizine(Zyncet) and sedating antihisaminics like Benadryl/Atarax will help.A short course of steroids like Prednisolone/Methylprednisolone will help.Cleaning the area with cold water and application of a soothing cream will help.You need to be examined by your doctor who may guide you further.
Customer: replied 6 years ago.

Due to a horrific MVA 10yrs ago, I have had enough interaction with doctors, hospitals, nurses, therapists and pharmacists that I feel as if I have as great knowledge about medical issues as they do. Of course, I don't, but years and years has drilled quite alot into my head. I do try to make informed decisions prior to introducing new medications, and I try to avoid doctors and hospitals if at all possible, but praise them for saving my life. I have seen so many doctors in 10 years that if I can treat something I have at home with home treatments, I am all for it. I do trust doctors and rely on their many many hours of study and so much on their experiences. That is what brought me to this site.

Why I was concerned enough to contact this site, you Dr., is because of number of odd presentations. I first saw a deep red raised area in a perfect circle, smooth flat top, no puncture marks, no redness or rash or raised areas anywhere around the outer area. I didn't feel any bites, like from a spider although brown recluse spiders are common here. It looked at first like a bad, deep cigarette burn (only larger in circumferance) but has no pain I would associate with a burn. It did itch and was extremely tender when I first noticed it. Being circular, maybe ringworn, but within an hour the shape and color ruled it out. That is when I immediately took Benedryl as a precaution. I took my temp, noticed it was elevated slightly, so I did take Tylenol to deal with that. The top of the leision went from raised and smooth, to more swollen, raised a bit higher, the top layer of skin on the lesion had been maybe dissolved or the full lesion came through it. It later evolved to having a lighter red area surrounding the lesion, not in any pattern (circular), swelling and itchy, but very tender. As I was searching for your sight, I noticed it has progressed yet again to some oozing, the flat top of the circular lesion having a bumpy appearance, still some itch but more pain, the swollen outside area growing somewhat, still itching and not as painful. Then a new area about the size of a fist that really itched. There are no striations to indication vein/blood travel. I understand you analysis of a secondary infection from an insect bite, maybe spider (yuck). I have medications, but will, on your recommendation, force myself to see my doctor tomorrow. I have cleaned it, applied and taken medication, just hoped it would be "apply Neosporin" and done! I thank you. My big circle lesion and I am not in medical danger, but still needs to see a medical doctor. You were informative and I will pass this site on to many others. You won my business and that of my friends and family. Peg

Expert:  Vakul Aren replied 6 years ago.
You can apply any emmollient/soothing cream,a steroid cream would also help.In all probability a bite would bethe most likely cause.If infection is suspected,a antibiotic ointment would do the trick.Please accept the answer to release my dues.Thanks.
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