MosaicED Brain Teaser!
An obese diabetic man walks into a bar, what does he say? “Ouch”
An obese diabetic man walks into a medical practice, what does he say? “Practice? I’ll come back on game day thanks, nah just kidding can you help me out? I have this painful red swollen spider bite on my arm.”
It looks red with indistinct borders.
What is the most likely diagnosis?
- A-Aranea morbum hominis
- B-Butterfly rash
- D-Contact dermatitis
- E-Eosinophilic cellulitis
- I-Papular urticaria
- J-Spider bite fever
- K-Stasis dermatitis
C-Cellulitis. Cellulitis is unilateral, painful, red swollen, warm, blistering, ulceration, abscesses, dimpled skin (peau de orange). It hits the immuno compromised and is often misattributed to a spider bite. A butterfly rash or malar rash is associated with SLE. Contact dermatitis has well demarcated borders and will appear in the pattern of the exposure. Eosinophilic cellulitis is localized erythema, edema, and induration with sharp borders and a green or gray hue. Erysipelas is a form of cellulitis usually caused by strep pyogenes, it has sharp raised borders. Lipodermatosclerosis presents with the inverted champagne bottle legs. Lymphedema is characterized by localized edema of an affected extremity, with induration, erythema, and secondary cutaneous changes such as hyperkeratosis, dyspigmentation, and wart-like architecture. Is a hypersensitivity reaction to an insect bite, the are characterised by being incredibly itchy. It is ill-defined, bilateral, pitting edema of the lower extremities, typically with erythema, hyperpigmentation, serous drainage, and superficial desquamation, it is differentiated from cellulitis as the legs should be non tender.
Sources:Image credit: Distinguishing cellulitis from its mimicsDermNet