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Suggest Treatment For Symptoms Of Itchy Dry Bug Bites

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Posted on Wed, 30 Sep 2015
Question: I got a bug bite in San Francisco about 1 month ago, it got really itchy and dry and turned white/scaly and now looks like this- i thought it was just dry skin but the ring is concerning as well as how long its lasted.
Just want to rule out ringworm, lymes etc
doctor
Answered by Dr. Dr. Kakkar (46 minutes later)
Brief Answer:
Likely possibility of ringworm; KOH scraping would be confirmatory

Detailed Answer:
Hello. Thank you for writing to us

I have gone through your query and I have also reviewed the Image.

I can see a round to oval, red patch which is dry, scaly and has a ring like margin.

Since it was itchy and always has been so, I would like to keep a possibility of Tinea/ ringworm. Another possibility is of Eczematous Dermatitis.
I would rule out lyme's because it is scaly and is itchy.
A KOH preparation made by scrapping a small amout of scale and placing it under 10X microscope would show fungal elements i.e hyphae, in case of a fungal infection.
You may try a topical antifungal for this e.g terbinafine 1% cream Or miconazole nitrate 2% cream Or clotrimazole 1% cream, twice daily for 2 weeks. Miconazole cream as well as clotrimazole cream is available otc. A fungal infection like this should clear in about 2-4 weeks.
An otc oral antihistamine e.g cetrizine 10 mg once daily will provide you symptomatic relief from itching.

Regards
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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Dr. Kakkar

Dermatologist

Practicing since :2002

Answered : 9612 Questions

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Suggest Treatment For Symptoms Of Itchy Dry Bug Bites

Brief Answer: Likely possibility of ringworm; KOH scraping would be confirmatory Detailed Answer: Hello. Thank you for writing to us I have gone through your query and I have also reviewed the Image. I can see a round to oval, red patch which is dry, scaly and has a ring like margin. Since it was itchy and always has been so, I would like to keep a possibility of Tinea/ ringworm. Another possibility is of Eczematous Dermatitis. I would rule out lyme's because it is scaly and is itchy. A KOH preparation made by scrapping a small amout of scale and placing it under 10X microscope would show fungal elements i.e hyphae, in case of a fungal infection. You may try a topical antifungal for this e.g terbinafine 1% cream Or miconazole nitrate 2% cream Or clotrimazole 1% cream, twice daily for 2 weeks. Miconazole cream as well as clotrimazole cream is available otc. A fungal infection like this should clear in about 2-4 weeks. An otc oral antihistamine e.g cetrizine 10 mg once daily will provide you symptomatic relief from itching. Regards