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Red And White Bumps On Wrists, Itching. Treated With Prednisone And Doxycycline. Have Low Grade Fever

Posted on Sat, 15 Sep 2012

Question: I have small red and white bumps on my inner wrists, inner arms up past the elbow on both sides. on my ankles and feet, in between my toes. they itch a lot! they have a scabbed center (probably from me scratching) and have turned purple and bruised looking around some of them. my back, stomach, and buttocks, back of thighs has what appears to be hives about 2-4 inches in diameter with a "dry" center. My left upper arm has the same. the skin is peeling in the center of my left upper arm. I have been treated with a prednisone dose pack, and a 80 mg Depomedrol injection. I am currently on Doxycyline. I see little improvement. I have had a low grade fever the past two evenings. I recently was at a lake and in the woods. This appeared 3 days after returning from the trip. The bumps started appearing on my lower back. help!

Answered by Dr. Praveen Rodrigues (1 hour later)

Hi there. I note your history with interest & have viewed what photographs you have posted. The former is crystal clear, the latter am afraid are not the best snaps i have seen. Having said this, it appears that the clue to your problem lies in your pen-ultimate statement : ' this appeared 3 days after returning from the trip to the outdoors..lake & woods'. Now, i am not from your parts. So suggest you google or ask your doctor @ ground0 to please try to ascertain what viral fevers or infections are endemic in literally 'the neck of the woods' that you were last seen/visiting. The common infections that are tick/louse borne are the 'endemic typhus', rocky mounted spotted fever etc & there are specific laboratory tests that pick these up nowadays so you may want to consider getting these tested for from your local laboratory once you have narrowed down a few or if they have some 'kit' testing for all these viral fevers. The skin lesions may also be some sort of hypersensitivity reaction to these viral or rickettsial infections. The treatment will present itself then. I dont mean to cast aspersions on your treating doctors' but i would not have started 2 types of steroids (just the depomedrol would suffice) & the doxycycline is a good antibiotic for your particular problem but may not do much if the origins of the problem are viral & which is why it is probably not working & may take some time to resolve. Drink plenty of fluids & keep yourself hydrated & take symptomatic treatment in the form of tylenol (acetaminophen) in the interim to keep the temperature under control. One may use a topical corticosteroid combined with a crotamiton cream mixed 1:1 & applied to those pesky areas twice/daily for 2-3 days. If no respite, please do make an appointment with your internist or dermatologist at the earliest.
I do hope this has been as lucid & candid & put yourmind at rest & pointed you in what i believe to be the 'right' direction. If so, please do close the query & GodSpeed..wish you a quick recovery & clear skin! Do please send in a feedback when time permits. Cheers!
Dr Praveen Rodrigues MD Dermatologist, Venereologist, Cosmetologist XXXXXXX Hospital, Bangalore, India

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar