Brief Answer:
Spider bites are not expected to cause lesions lasting so long

Detailed Answer:

Hello,

Please let me know:

Where is it located?
Do you have other symptoms along with the skin problem?
Do you have any other chronic medical conditions or take any medication?

Could you send a few pictures of the swelling, please? You can simply upload/attach them to the reports section of this web-page...

On the other hand, it is certain that spider bites can cause swelling and pain with dark spots on top of the lesion but it is expected to heal within weeks. The fact that it is a month now and you still have the lesion come and go means that it may not be a spider bite or otherwise got complicated with some other skin concerns.

I'd suggest seeing a Dermatologist to examine you and rule out other causes of skin lesions. Your doctor may also require a skin biopsy to better understand the diagnosis.

So to conclude I would say:
- please see your doctor for a better diagnosis as a spider bite should not go on for months or go on and off
- other skin lesions should be ruled out and biopsy might be indicated if the appearance of the lesion is not typical for a certain condition.
- meanwhile make sure you do not use anything (no tape please) on the lesion so there is no chance of irritating it, vaseline locally can be used if the area is dry, otherwise, do not use anything else without the recommendation of a doctor.

I hope this is helpful and answers to your question but please feel free to reply if more clarification is needed on this.

Regards,
Dr. Zotaj Antoneta, General & Family Physician

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Brief Answer:
The treatment recommended- callus has to be considered if hard area present

Detailed Answer:

Hello,

By the information provided it is clear this is not a spider bite and there is nothing to worry related to this. I would recommend you to use a combination of a local steroid and antifungal twice a day for 7 days. This will help in case there is some fungal infection or local irritation due to dermatitis/eczema which are very common causes of redness in that area.

That area is high risk for callus so If you have a hard area at the center of the lesion than a callus (or skin horn) is likely so you will need to talk to your doctor on possible need to remove it.

To conclude I would say:
- if you have a hard area on the lesion probably a callus is the case and you need to see a doctor to examine you and evaluate the need to remove it
- if you do not have a hard area in the center of the lesion than use the combination of steroids and antifungal twice a day for up to 7 days to try to reduce inflammation and with the yeast infection if it is the case. This treatment is well tolerated and is highly effective for these 2 more common problems in that area. Please do not use the steroid alone as it might worsen the yeast infection if there is a yeast infection. Combining both is safer and more likely to help.
- if no improvement in 4-5 days or if you notice any worsening please see your doctor as there are other more rare conditions to be considered and be tested for if these do not help.
- meanwhile please make sure you use cotton socks and wear shoes that get some air so you do not develop much moist locally and worsen the lesion.

Hope I have answered your query.

Regards,
Dr. Zotaj Antoneta, General & Family Physician

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