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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest Treatment For Small Itchy Blisters On The Thighs

I had a tick bite on left inner thigh from recent camping, which i suspect the tick was there for about less than 10hrs. I took the tick out and did not have any symptoms of lyme disease. However after 2 weeks, i had this rash on right wrist that started with a single welt, was very itchy, spreading and getting bigger, and formed blisters. Rashes began to appear on the other wrist in streaks, and scattered single welts on waistband area, and inner and outer thighs. I suspect they are scabies since I deal with homeless people at work. I used permethrin 5% and currently on tapered prednisone. I noticed the blisters started to dry up, and healing well. But, i noticed the rash are getting bigger, still itchy, but without blisters. Could this be a sign of ineffective or not enough scabies treatment? A misdiagnosis? Or possibly a symptom of lyme disease. I don t have any other symptoms besides the rashes. No fever, CNS symptoms, joint pain, weakness, etc. Thank you.
Wed, 5 Jul 2017
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Dermatologist 's  Response
hi,
thank you for putting up your query on HCM.
as per your history, you may have allergic reaction which may be caused due to tick bite or because of contact with allergens as you were on camping.

-- scabies won't affect the centre of the body, it affects either genitals or hands and feet. so suspecting scabies on the basis of few rashes may be a wrong diagnosis.
-- since you have used permethrin for the same, it would have also caused allergic reaction.
-- since , there is no history of systemic symptoms like fever, joint, cns involvement, Lyme's disease can be ruled out. plus Lyme's disease rash looks like a bull's eye. centre will be raised and red and spreads in a circular manner.
-- I would recommend you to apply topical potent corticosteroids like betamethasone valerate (0.1%) cream twice a day over the lesions.
-- since you are already on oral corticosteroids, continue taking, but under the guidance of dermatologist.
-- you may take tab levocetrizine twice a day for itching .
if anything serious, do consult a dermatologist nearby.
wishing you healthy skin.
thank you
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Suggest Treatment For Small Itchy Blisters On The Thighs

hi, thank you for putting up your query on HCM. as per your history, you may have allergic reaction which may be caused due to tick bite or because of contact with allergens as you were on camping. -- scabies won t affect the centre of the body, it affects either genitals or hands and feet. so suspecting scabies on the basis of few rashes may be a wrong diagnosis. -- since you have used permethrin for the same, it would have also caused allergic reaction. -- since , there is no history of systemic symptoms like fever, joint, cns involvement, Lyme s disease can be ruled out. plus Lyme s disease rash looks like a bull s eye. centre will be raised and red and spreads in a circular manner. -- I would recommend you to apply topical potent corticosteroids like betamethasone valerate (0.1%) cream twice a day over the lesions. -- since you are already on oral corticosteroids, continue taking, but under the guidance of dermatologist. -- you may take tab levocetrizine twice a day for itching . if anything serious, do consult a dermatologist nearby. wishing you healthy skin. thank you