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Experienced intense, painful burning on little toe. Developed blisters. Diagnosed as allergic reaction to insect bites. Advise?

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Practicing since : 2009
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Hello, I saw a nurse practitioner yesterday to address an issue I am having with the little toe on my right foot. 5 days ago, experienced intense, painful itching/burning all over that toe, including the top of foot area just above the toe. 3 days ago, developed large, flat white blister between little toe and 4th toe, intermittent burning pain, accompanied by swelling. Suspected fungal infection, and attempted to treat with antifungal cream I had on hand; seemed to have no effect. Yesterday morning, toe was extremely swollen and numb (still itchy, and feels like someone tied a string around the base of toe too tightly) and difficult to move so I sought medical help. Nurse practitioner examined and said did not look like athlete's foot (confined to area of one toe only), but said she had never seen anything like it (mentioning that by just visually looking at my foot, my toe appeared so swollen that she would have assumed it broken). She discovered 2 additional blisters immediately underneath the toe (that I could not see). Diagnosed my issue as possible allergic reaction to insect bites and recommended I take an antihistamine, use an antihistamine cream, and ice the toe (thinking the numbness was related to the swelling), following up if no improvement. More than 24 hours later, the itching seems somewhat less, but the icing seems to be having no effect on the swelling, the numbness in the toe continues, and the white blisters have gotten larger, with mildly red discoloration spreading to the top of my toe. I have had a bad reaction to a spider bite in the past -- any idea what this could be? Thank you very much!
Posted Wed, 4 Sep 2013 in Infections
Answered by Dr. Shoaib Khan 45 minutes later
Brief Answer:
Possible insect bite, continue treatment

Detailed Answer:
Hello and welcome.

Thank you for writing to us.

Based on the information provided and treatment tried, it does sound like a possible insect bite resulting in a severe allergic reaction, you also have to option of uploading pictures to our discussion.

What is important to note here is that there is a slight response to anti-histamine medication. I would thus advice the use of both anti-histamine topical application (cream) as well as systemic form (oral tablet). Along with this, an anti-inflammatory medication would really help in bringing down the swelling. In the meantime continue with the ice application as this reduces swelling, once the swelling comes down begin the application of warm compresses which would promote circulation and improve healing.

Wishing you a speedy recovery. Please visit your doctor if your presentation does not improve from its current state in the next 3-10 days.

Take care.
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