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What Causes Swollen Red Circle Above Left Ankle?
Question: hello,
approximately a week ago a weird red circle developed a few inches above my left ankle. i noticed it while hiking and assumed it was a spider bite..... mostly due to being unsure what it is, but there are no fang marks. the area has since tripled in size and is hot and swollen. it's very simolar to how an infection would act. i don't feel weird or off but do have a very low fever 99.3. my normal is 98.3-98.6. i have gone to a doctor and they put me on bactrim. diagnosis was some sort of cellulitis. it's very tender (the areq) and even marking the area with a sharpy hurt. it's sore to walk on and does very well when i have my leg raised. any thoughts? (p.s. u will see a scar in the pic on the bottom of the area... that's a previpus surgery) the area has always been relatively perfect circle. there were no cuts in that arra... so if infected i am not sure where it came from.
approximately a week ago a weird red circle developed a few inches above my left ankle. i noticed it while hiking and assumed it was a spider bite..... mostly due to being unsure what it is, but there are no fang marks. the area has since tripled in size and is hot and swollen. it's very simolar to how an infection would act. i don't feel weird or off but do have a very low fever 99.3. my normal is 98.3-98.6. i have gone to a doctor and they put me on bactrim. diagnosis was some sort of cellulitis. it's very tender (the areq) and even marking the area with a sharpy hurt. it's sore to walk on and does very well when i have my leg raised. any thoughts? (p.s. u will see a scar in the pic on the bottom of the area... that's a previpus surgery) the area has always been relatively perfect circle. there were no cuts in that arra... so if infected i am not sure where it came from.
Brief Answer:
Possibility of erythema nodosum/ panniculitis; Biopsy would be confirmatory
Detailed Answer:
Hello. Thank you for writing to us
I have gone through your query in detail and I have also reviewed the Images.
I suggest a possibility of either Erythema Nodosum (EN) Or infectious panniculitis.
Erythema Nodosum is a type of panniculitis i.e inflammation of subcutaneous fat. A skin biopsy is confirmatory.
It can happen in response to i.e hypersensitivity reaction to various causes like...
-Infections (Viral infections; Bacterial infections e.g sore throat, yersinia infections; Mycobacterial infections e.g tuberculosis; Parasitic infections etc)
-Drugs
-Sarcoidosis
-Inflammatory bowel disease etc
-Most cases are Idiopathic i.e no known cause.
EN usually presents as tender, swollen nodules or plaques/ patches on shins and area above ankles. New crops of erythema nodosum may occur over a number of weeks. Lesions may merge with each other to form larger plaques.
Lesions gradually fade over weeks with bruise like changes
There may be associated low grade fever, malaise, joint pain etc in erythema nodosum.
Treatment is with Oral antiinflammatory/ painkillers like ibuprofen Or diclofenac for symptomatic relief from pain.
Restricting activities for a few days is also helpful.
The other possibility is of Infectious Panniculitis. Infection may come through blood stream.
I suggest you to continue with bactrim.
You may add an oral antiinflammatory e.g Ibuprofen, twice or thrice daily for symptomatic relief from pain and swelling.
Regards
Possibility of erythema nodosum/ panniculitis; Biopsy would be confirmatory
Detailed Answer:
Hello. Thank you for writing to us
I have gone through your query in detail and I have also reviewed the Images.
I suggest a possibility of either Erythema Nodosum (EN) Or infectious panniculitis.
Erythema Nodosum is a type of panniculitis i.e inflammation of subcutaneous fat. A skin biopsy is confirmatory.
It can happen in response to i.e hypersensitivity reaction to various causes like...
-Infections (Viral infections; Bacterial infections e.g sore throat, yersinia infections; Mycobacterial infections e.g tuberculosis; Parasitic infections etc)
-Drugs
-Sarcoidosis
-Inflammatory bowel disease etc
-Most cases are Idiopathic i.e no known cause.
EN usually presents as tender, swollen nodules or plaques/ patches on shins and area above ankles. New crops of erythema nodosum may occur over a number of weeks. Lesions may merge with each other to form larger plaques.
Lesions gradually fade over weeks with bruise like changes
There may be associated low grade fever, malaise, joint pain etc in erythema nodosum.
Treatment is with Oral antiinflammatory/ painkillers like ibuprofen Or diclofenac for symptomatic relief from pain.
Restricting activities for a few days is also helpful.
The other possibility is of Infectious Panniculitis. Infection may come through blood stream.
I suggest you to continue with bactrim.
You may add an oral antiinflammatory e.g Ibuprofen, twice or thrice daily for symptomatic relief from pain and swelling.
Regards
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
thank you for ur response. is this contagious? is it common to be in such a perfect circle? it's so bizarre how accurate it is. everyone thinks it looks like a tick bite on crack.
Brief Answer:
Erythema Nodosum is not contagious
Detailed Answer:
Hi.
EN is not contagious.
Individual lesions can merge together to give rise to a ring or circle which may expand before fading away with bruise like changes.
Regards
Erythema Nodosum is not contagious
Detailed Answer:
Hi.
EN is not contagious.
Individual lesions can merge together to give rise to a ring or circle which may expand before fading away with bruise like changes.
Regards
Note: Hope the answers resolves your concerns, however for further guidance of skin related queries consult our Dermatologist.Click here to book a consultation
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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