What Causes Small Red Patch On Neck With Itching After Insect Bite?

Posted on Mon, 16 Jun 2014

Question: An insect I did not see bit me on the neck Wednesday morning and left a small red circle, with itching, that has expanded to four times it size, now to a red square of 2 inches with a thin red line extending toward my ear. Because I began getting flashes of headache pain (and I never get headaches) I now wonder whether I should go to an emergency room in case there is anything like blood poisoning. Neither Benadryl cream nor Cortaid have reduced the redness.

Answered by Dr. Ilyas Patel (1 hour later)

Brief Answer:
Please answer and post the photos.

Detailed Answer:
Hi,

Welcome to HCM.

As you said that you have erythematous patch on side of neck extending to ear and there itching and burning. You complained of severe headache. There is possibility of insect toxic dermatitis. Herpes zoster a viral infection should be kept in mind. For firm diagnosis,I would like to have answers of few questions.

1) past history of such lesion?

2) please describe the lesion..blisters,nodules,patch..

3) is there oozing?

4) skin lesions elsewhere?

5) Do you have history of any other medical illness?

6) any treatment taken for the skin disease?

Please answer above questions and post the photos of the affected parts, so that I can help you in better ways.

Thanks.

Dr. Ilyas Patel MD

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Ilyas Patel (7 hours later)

No to five questions. I have had shingles before, many years ago.

Answered by Dr. Ilyas Patel (5 hours later)

Brief Answer:
Insect toxin induced dermatitis.

Detailed Answer:
Hi,

Welcome back.

You have red patch on neck gradually enlarged. And extend to ear. The most probable diagnosis is insect toxin induced dermatitis. You may be right. There may be insect bite unknowingly.There may be itching and burning in patch.. Secondary bacterial infection may be there.

Herpes zoster possibility is very less as there are no vesicular eruptios. However, photo might be helpful for perfect diagnosis,but you did not posted.

Still, I would like to advise you following treatment.

You take short and tappering course of steroids for two weeks. And antihisttaminics like levocetirizine may be taken to relieve itch. Antibitics like cephalosporin 250 mg thrice a day for one week may be taken. Apply antibiotic like nadifloxacin cream.
Analgesic like nimesulide 200 mg may be taken twice a day to relieve headache.

I hope this answer might be helpful to you.

Still, any query..you are welcome.

Wishing you early recovery.

Thanks.

Dr. Ilyas Patel MD

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Ilyas Patel (20 hours later)

I went to an Urgent Care facility yesterday morning and was given antibiotics and told to follow-up with my doctor after the weekend or go to Emergency Hospital if the red area expanded. Thank you.

Answered by Dr. Ilyas Patel (23 hours later)

Brief Answer:
Insect bite toxic dermatitis

Detailed Answer:
Hi,

Welcome back.

Take regular treatment as suggested and have follow up with your doctor.

You may become alright.

Thanks.

Dr. Ilyas Patel MD

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. Vinay Bhardwaj