Photo Quiz Question – Q.002 – June 17, 2011
It’s summertime . . . better watch out for this problem. Anyone can get it – no one is truly immune.
What does the above image depict? Is there any treatment? Should the patient be quarantined?
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Photo courtesy of Wikimedia Commons
About Cynthia J. Koelker, MD
CYNTHIA J KOELKER , MD is a board-certified family physician with over twenty years of clinical experience. A member of American Mensa, Dr. Koelker holds degrees in biology, humanities, medicine, and music from M.I.T., Case Western Reserve University School of Medicine, and the University of Akron. She served in the National Health Service Corps to finance her medical education.
As a recent “recipient” of this affliction on a trip to a rural farm, I’d say those are chigger bites. No quarantine necessary… care is topical OTC cortisone and/or anti-histamine cream/ointment, plus thorough decontamination of clothing. Patient should be told the importance of not scratching the lesions since secondary infection may develop. Inflamed bites resolve naturally within 10-14 days in most cases. In cases of severe itching, a prescription anti-histamine such as Atarax (hydroxyzine HCl) might be indicated. Avoid heat and/or hot water, as these aggravate itching; cold packs and cool water offer relief. How to avoid chigger bites? Wear long pants, boots and tuck cuffs/pant bottoms into socks. An insect repellent containing DEET works to repel chiggers also. Change clothes promptly after being in the field for an extended period.
We are guessing poison ivy or chicken pox.
I’m thinking poison ivy or chiggers.
I vote chiggers.
I note some papules.
Looks like impetigo from ant or mosquito bites.
Close . . .
Just looking at the picture makes me want to scratch!
Pityriasis rosea? Maybe, and yes it will go away by itself, if it is, guess it could also be perhaps an allergy, but my guess is you’re going to shoot me down with something else, but hey, I made a guess 🙂
Yes, Craig, thanks for putting yourself out there!
I know it’s often difficult to tell from a picture, but pityriasis is not usually this red, is often more symmetric, is usually more prominent on the back, and tends to follow the skin lines.
Still, you are correct, that pityriasis rosea will resolve untreated . . . but will this rash?
Could be swimmer’s itch if the travel history matches.
Looks like chiggers to me.