"spider bite" first noticed 1wk ago. Afebrile, no crust. Pa | Figure 1

Case Summary

"spider bite" first noticed 1 week ago. Afebrile, no crust. Painless. Slightly pruritic. Ulcerated area on bridge of nose not initially present and another smaller lesion on tip of nose appeared 4 days ago. PMH: HTN, gout. Reports he recently started taking Aleve for gout-related pain. Lives in urban area, NE US. Maybe fixed drug eruption (?) I'm a psych nurse so definitely conjecture.

More about this case

Resolved

Similar cases

1. 20F with sudden pain and tenderness at this site. The smaller outlined area is what I am thinking is the actual bite site. Pt went to a walk in urgent care 2 days ago and was told if the area got darker or bigger to call EMS. Per the pt, it has gotten significantly darker. All vitals stable. Area is still painful to touch. Any thoughts?

2. 5 yo girl from a rural area, started 3 months ago with a "little pimple" on the knee. Any ideas?

3. 20yo female from northern Honduras, 2 weeks ago, traveled and stayed in western Honduras, got probably mosquito bites. Started a week ago with vesicles displayed in first images in both legs, after a week decided to shave her legs, and two days after, lesions became like the ones shown in subsequent pictures. Started Dicloxacillin 2 days ago with no improvement. Mild fever and diarrhea last night. Area is endemic of #Leishmaniasis. Opinions?

4. 5 year old male presents with itchy, painful welts. Originally started off as pimple-like areas but currently presents on the Left antecubital space and the Left side of the abdomen. Onset on Left antecubital space, 5 days ago. Vomited twice 4 days ago. Opinions?

Additional Similar Cases

• A 52-year-old man presented with a 20-minute history of chest pain radiating to the left shoulder and neck, associated with dyspnea and diaphoresis. He had a history of hypertension, long-term smoking, and a sedentary lifestyle. Physical examination revealed bibasilar crackles noted on lung auscultation.

• A 28-year-old woman presented with a 3-day history of intense pruritus over the lower back. She reported no recent travel or exposure to new environments.

• A 4-month-old male infant presented with skin lesions localized to the chin for the past 3 days. Physical examination revealed multiple small pustules with surrounding inflammatory signs on the chin.

• Patient in late teens presenting after a collapse, no chest pain, no previous cardiac history.