
What Causes Circle Around The Insect Bite In The Upper Arm?

Early Localized Lyme disease.
Detailed Answer:
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Consult his physician for a prescription of Cefuroxime in place of Doxycycline if you feel that Doxycycline isn't working good for him.
He is having Early Localized Lyme disease, and the change in skin temperature is actually due to cellulitis and We can clearly see the Erythema Migrans Rash that is typical to the lyme.
He will get gradually better. If you feel he is having some joint, muscles, neurological manifestations (usually happens to appear after 30 days of appearance of rash, if not controlled) you should seek medical attention.
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DR. XXXXXXX HANIF
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