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  • New skin ulcer - bug bite?

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    Old 06-28-2020, 10:44 AM   #1
    prairieperson
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    Question New skin ulcer - bug bite?

    I have an ulcer on my inner right ankle, just posterior to the medial malleolus. It is progressing rapidly.

    Several days ago, after returning from working in the landscape and garden, I noticed a lesion on my ankle. It appeared to be some sort of small scrape that had lifted most of the skin and left it ragged. I cleaned the wound and as I removed the dead skin, I notice small black dots like pepper fairly adhered to the skin and some of the tissue below. I removed what I could, but I may have missed some of the smallest ones. Over the next day, the lesion scabbed over as expected. The next day it became very itchy but didn't change much. By the following day (yesterday morning) it began to change quickly.

    Yesterday morning the center of the lesion was no longer scabbed but ulcerated with a thin red rim. Throughout the day, the redness continued to spread. It continued to be very itchy. I was able to start using some warm moist saline-soaked compresses later in the afternoon and evening.

    I was awakened today at 3 a.m. from the itching. The lesion had the same size ulceration, but the redness had spread, became a beefy red and firm. Very little pain. Clear discharge. Pale pink skin in a larger area around the lesion. I took an antihistamine to see if it would help with the itching and is was very effective!

    I went to Urgent Care early this morning. The provider was not sure what was causing the ulceration, but took a culture and started me on generic Bactrim.

    Since then, now I have swelling in the ankle on that side with some pitting edema. The right ankle measures larger than the left. The beefy red area is now developing tiny blisters. I don't have a fever and I otherwise am well.

    What is particularly curious is the very adherent black dots. On close inspection of the ulcerated area, I believe there are still a couple of very tiny pieces present.

    Thanks so much!

     
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