It looks like impetigo to me.
http://my.webmd.com/content/article/8/1680_54521

Mark,
Brother Eric Salmon here.

Do you need me to get out my pathology books, or have you had a medical professional look at this?

Get one of the island's feral dogs to lick it, ASAP.

Jesus fucking Christ that is gross. I did not need to see that.

Maybe there's a way we can put a positive spin on the shin sore until someone finds out what it is... Mark, how do you feel about possibly saving 50-percent on shoes for rest of your life?

Here is a picture of impetigo:

http://www.mja.com.au/public/issues/176_12...2/got10354_fm-1.jpg

Here is Necrotizing Fasciitis (flesh eating bacteria)

http://www.embbs.com/img/i000000a.jpg

BTW: I heard about a case involving NF a couple of weeks ago. A guy got poison ivy on his hand. He scratched his bare ass and it spread to there. He scratched his ass so much so much it turned into a very bad case. The pustuls were so big that he decided to puncture them with a unclean carving knife. Not bright. The knife had the bacteria on it necessary to cause the NF. Ate most of his ass away. Should be included in the Darwin awards.

Note to self: In the future, do not look at boingboing while eating lunch.

I have a sore on my anus I was hoping you all could help me diagnose... Pic to follow as soon as I can find my tripod and macro lens...

Anyway, bury that thing in an antibiotic, but first douse it in Hydrogen Peroxide, that should wipe it out if it's a simple bacteria and should prevent a secondary infection. If it's progressing as fast as you say it is, I'd jump into a medical forum, or call your doc back in the states and email the pic to him, I wouldn't rely on BoingBoingers for medical advice.

(Note: I'm not a doctor but I play one with the girl next door.)

It's not impetigo if it doesn't itch. If it were ringworm, there would usually be a clearing in the middle of the reddish patch. So I'm guessing it's a bacterial infection- go with hydrogen peroxide and topical antibiotics.

jesus christ i'll think of that impetigo pic the next time i'm bellyaching about a little old cold sore.

I've had impetigo on my arm and no it didn't itch - it looked terrible but didn't really hurt. But it won't heal up without presciption antibiotics if it is impetigo. It will just get larger. I tried the over the counter stuff and hydrogen peroxide to no avail - till I had it properly diagnosed 3 weeks later.

welcome to the tropics!

I would say (a) if there is any kind of local doctor of the general-practice variety, I bet he'd be able to help just fine -- dermatologist! bah!, and (b) the peroxide/antibiotics are a good plan.

Handy to keep some topical antibacterial goo around, because in the tropics, skin and scratch infections take hold a lot more often than they do in non-tropical countries, in my experience.

PS: that picture is really gross.

gottabe, you're just lucky I don't post a pic of a rodent ulcer....

Actually, I will post a link, but just don't look at the bottom few images:

http://www.shorelaser.com/ClinPixBCC.htm

Check with the other islanders... maybe it's a local thing caused by eating too many green coconuts and letting small lizards nest on your skin.

Actually, it looks like a trypanosomiasis chancre (http://www.cdc.gov/ncidod/eid/vol8no1/01-0130G1.htm). But you're not in Africa. Maybe some other kind of bug-laying-eggs in your skin disease. Probably a good idea to consult a doctor somewhere in the islands... if it's like a tsetse bite, you won't live very long if you don't get treatment soon.

Mark's icky-skin-sore picture has nothing on the badly-concieved fancy donuts produced by the place that supplies my employer's Friday Morning Donut Feast.

The proprieters seem to think More Features are Better. One confection consisted of a crusty fried donut filled with "Bavarian cream" (pus) topped with whipped cream and translucent red cherry goop. I call it an infected pustulette.

Grossest use of lazyweb ever.

All those people moaning about the posts on bb and asking for Mark to come back...

I hope you're happy now. :)

FWIW, here's a ringworm page with an image:

http://www.nlm.nih.gov/medlineplus/ency/imagepages/2557.htm

A highly pronounced bull's eye rash from lyme disease:

http://www.nlm.nih.gov/medlineplus/ency/imagepages/1027.htm


Here's a "self-care flowchart" (no photos) for rashes:

http://familydoctor.org/flowcharts/545.html

All from the medlineplus searches:

http://www.nlm.nih.gov/medlineplus/medlineplus.html

Syphilis!

Been with any disreputable island girls lately?

From just looking at it and the fact that it is not sore or itchy, it could be third stage syphilis.

http://www.cdc.gov/nchstp/dstd/Fact_Sheets/Syphilis_Facts.htm

that is definitely a nasty lesion
I think you should post a "Hello Kitty" item
to offset the distressingly bad juju surrounding
such a hideous post
amputation may be the only recourse
if it doesn't heal soon
just one veterinarian's opinion;surely there is some sort of island nurse or healer you can consult
don't let it go;time is of the essence!

My girl Liz here who works for a dermatology professor says it's probably ring worm. Impetigo would have probably spread faster and created more sores. Here are some lecture notes with more information:

http://www.emlyn.net/pdf/Tinea_Corporis.pdf

Syphilis? hmm. Have you been giving shin rides to anyone, Mark?

Hard to find good pictures of syphilis ulcers. While on stds,
it doesn't look like shingles. :^)

http://www.niaid.nih.gov/shingles/photos.htm

word to the wise:

don't try google image searching for "rash" unless you're ready to lose your appetite!

http://images.google.com/images?num=100&hl...&q=rash&sa=N&tab=wi

Tis but a scratch.

My guess from very limited data: ringworm which is a fungus that you can treat with whatever you have for athlete's foot or jock itch. Another possibility is bite of something creepy, e.g. spider.

xparxy = board-certified emergency physician, NOT a dermatologist.

douhh!!!
I'd say from my experience in tropical ecology, looks like you got the lesh..... no not the grateful dead bass player but leishmaniasis;
http://www.cdc.gov/ncidod/dpd/parasites/leishmania/default.htm

Although, you're not in a hot spot now, if you ever traveled asia,africa, s.¢ral america it could be it. you also get lots of alarming pictures if you google 'leshmaniasis'.

welcome to the tropics!

Frankly, looking at all of the wonderful pictures people have posted...

It looks to me like a spider bite...

It doesn't look like ringworm to me (our dogs have had ringworm and it didn't look like that)... But it does look like a spider bite, I've had some that acted like that...

Still, it would worry the heck out of me.

Z.

in the link from /m27

"Leishmaniasis is not found in Australia or Oceania (that is, islands in the Pacific, including Melanesia, Micronesia, and Polynesia)."

I guess that rules that one out...

Z.

Do you have any other symptoms? Swollen glands, flulike symptoms, fever? Are you in an area with a high preponderance of mosquitos, of ticks, of spiders? Does it hurt? Is it dry or oily? Have you seen a doctor?

I refuse to link to any of the pics I found when searching for 'brown recluse bite' on Google, but my first thought, after "He should go see a doctor" was "spider bite."

NOT A COLD. PROBABLY NOT LUPUS.
(I realize few of us are experts in tropical skin diseases, but if we swarm tiny bits of what we DO know, we may be able to solve this mystery.)

I traveled a year in the Coral Sea ,Torres Straits, New Guinea and these sores were something that one had to treat on a regular basis. This is what worked for us: There's a liquid antiseptic that's sold in Australia and NZ that is used topically and diluted as a mouthwash (the name escapes me)..not unlike Lysterine but stronger.. we used it "straight" from the bottle topically. I would notice an itch about a day after having been bit by a mosquito. If you scratched it, the skin would fall away revealing the ulceration. This is gonna hurt: you take a toothbrush soaked in the antiseptic and scrub the site thoroughly, then use the neosporin. However, don't cover it up. If you wait too long to treat it, it will be almost too painful to do the toobrush scrubbing ritual. This treatment never failed. I did know someone that didn't treat his sores and had his legs covered in them within a couple of months and had to be treated at a clinic. Quick treatment is essential.

I'm with Ernie, I think we all do know you should see a doctor, so if you combine all of that knowledge, and actually see a doctor, I'm certain the mystery will be solved! :)

Unicorn-horn jabs have been known to fester up like that.

Looks like you've caught MBlaster. Didn't think Microsoft products could lead to lesions did you?

Seriously, good luck with that nasty thing. Sorry we've been of little help.

Edited by author 08-18-2003 07:37 PM
I think the product Phillip refers to is "Tea Tree Oil". It's used deluted in mouthwashes and is a pretty strong anti-fungal that's shown effectiveness against resistant staph infections.
 Google up tea-tree oil; you'll find lots of stuff. If you can find the full strength stuff it works wonders; my BF used it to get rid of "Yellow Toenail" jungle rot he got in Panama.
It also knocks out ring-worm fast.

That's definitely not ringworm, unless you had a ringworm infection and decided to drive a nail into the centre of it.

...

This is in a directory of wonderful things?

It might just be a Staph infection.

I had a couple surfer friends who lived in Hawaii and they were pretty paranoid about infections because in the tropics soars just don't dry up and heal easily. They cleaned their cuts often, using alcohol or hydrogen peroxide, and tried to keep them dry.

They also used polysporin, which is the dry version of neosporin, and things like liquid bandage, which disinfects and covers cuts well.

They also swore by Noni, which is a Hawaiian fruit know for it's healing. They would put Noni oil on cuts and drink the stuff (it tastes awful) if they thought they were getting an infection.

About Staph and marine cuts:
http://www.aloha.com/~lifeguards/alsting3.html

http://www.highway60.com/mark/brs/linda_bite.htm
do they have brown recluses in rarotonga? tourniquet! and if that does not work amputate!

otherwise yeah, mini-unicorn bite :D hope the sore heals, good luck :D

Kickstart (/m38), no boingboing is no longer a directory, it
is merely 'fair and balanced'. As in 'fair skined' and 'color
balanced' rashes.

Having dealt with my fair share of fungal blight while living Bermuda, I can tell you that ain't ringworm. Ringworm doesn't create a open sore like that. It's just an itchy rash that sometimes is ring-like, but not always.

Keep it clean and dry, and keep an eye on it. If the sore keeps growing, seek medical attention before you lose a limb.

Ha ha. I hope.

I've always had nasty reactions to spider and mosquito bites. The only time one of them got that bright red halo was from one I had on the inside of my wrist. Because of its location, I frequently abraded it, and it became very irritated. It looked pretty much like your image here, right up to the point where a red streak (maybe 1/4" wide) appeared between the bite and traversed up the inside of my arm.

The doctor said it had turned to blood-poisoning with the onset of that symptom. If you get a streak, hie thee to a medic. You don't want to get on the downhill side of blood-poisoning.

The brand of antiseptic that we used to scrub those sores thoroughly with a toothbrush was called Dettol. Come to think of it, we never used it diluted for mouthwash, but only topically for coral cuts and those ulcers. I checked the ingredients and it appears to be a stronger version of what we have on the shelf here in the US as Bactine.

Coconut oil has antimicrobial properties, so wouldn't hurt to give it a try. You're likely to have it in good supply there...

Edited by author 08-18-2003 11:54 PM
It's not ringworm.

in guam we got those - never knew if it was a bug bite or what - but being sweaty, maybe not too clean, in the ocean (everyday/all day), they just never healed well -

what we did: scrubbed them with bristle brush first - bleeds, but cleans it out (we were camping...maybe you're in better conditions) - dressed them with HP and kept them dry - in a couple of days all was well...

but the little "sore" part remained for months - not to worry though - wounds just don't heal that well in the tropics.

also: you can no doubt find some sort of ointment - usually some terrible medicinal goo that looks like zinc peroxide can be obtained from a clinic - rub it on the CLEAN wounds it can help more than the anti-biotic cream because it makes an "air-tight" bandaid goo thing...

good luck and don't fret.

I lived in Mexico a few years, and had really terrific international insurance - the company specialized in third world. It was cheap, and wonderful, they paid total claims on everything, even some holistic medicine claims I didn't expect.

I contracted it individually, but I think I heard of the company from working with School for International Training. I can't find the company name in my files, and I'm really not sure on this - but you might e-mail info@sit.edu. The webite is http://www.sit.edu/.

I'm sure you guys are insured, but this company had a 1-800 number to America - to find an English-speaking local doctor if that was the need, or to ask an American health person a question.

I had a few usual health probs and always visited my own Mexican doctors, but the service would help us with translating prescription names and stuff. That worked for me; I could go to doctors I knew and trusted from local connections. Otherwise I would have traveled and paid more before reimbursement for going to unknown American or Canadian clinics and such.

I also had a panicky moment - involving a nasty rash and swelling from US tattoo ink in the middle of the night after my homeland vacation. I got to 1-800 a nice nurse from the USA who said it was prolly just allergic reaction, and to call my doc in the morning. It all worked out fine. That was priceless.

I'm not a doctor, but it doesn't look like anything I've had before. You should be aware, if you're not already, that some insect species in your part of the world lay their eggs under the skin of mammals, causing a nasty sore until they hatch out.

Keep it clean and have it looked at at earliest opportunity. I'm betting your nearest clinic is well acquainted with your affliction, whatever it is, and a full-blown dermotologist is unneccessary.

Thanks for the suggestions, all. I scrubbed it with tea tree oil and a toothbrush. The scab in the center came off. All that's left is a smoothish red oval. Went to the pharmacist and she swears its ringworm. Gave me a tube of Clotrimazole Anti-fungal Cream. I'm also taking Cephalexin antibiotics, just to be safe. I hope it goes away. I think I have another sore near my armpit.

Edited by author 08-19-2003 08:17 AM
<img src="http://www.dermnetnz.org/img/tinea/tcblis.jpg">

Ringworm does have many manifestations, including this one, above. I'd think we should let the medical personnel over there have their chance before we diagnose via Internet.

BTW: taking antibiotics while you have certain fungal infections can make the fungal infection worse...ask any woman who has had a yeast infection

And hey, Wiley!

this looks just like something I had last month. it was a staph infected insect bite. the nurse said there had many here recently and the staph was highly antibiotic resistant. Very important to treat with the correct antibiotic. have a culture made if possible to determine the correct meds. if this is a resistant bug, treatment can be difficult if not caught in time.

Hey Mr. Rushkoff, how you is.
write me at weevil@wileywiggins.com

If you're into self-diagnosis, the University of Iowa has an awesome image collection of all manner of skin lesions.
http://tray.dermatology.uiowa.edu/ImageBase.html
I'd say no on the ringworm, too. I'm a mom and have seen lots of cases of it -- sometimes it's a ring and sometimes a circle, reddish, raised, but I've never seen it broken like that. If it's around your mouth-nose, it may be impetigo, which can go from bad to worse very quickly and spreads like crazy. But you should really see a doctor, even if it's not one who specializes in skin ailments, before it turns into something like those pictures.

Edited by author 08-19-2003 05:41 PM
I...gulp...ah...oooowwwwwoooo...hope you're okay.

This reminds me of the Dilbert strip:

Catbert: "We're switching to a cafeteria-style health insurance program. You'll wander around the cafeteria asking, 'Does anyone know what this red sore is?' "

(Great joke, K. Lastima! Oh, woe, is Mark.)

unicorns unicorns unicorns unicorns

just keep pouring peroxide and alcohol on it.. it should go away.. or maybe itll just make it stronger and it will grow to consume you.. good times either way.

That is NOT ringworm. The scab falling off by itself should be enough of a differential diagnosis to tell any medical professional THAT. And I would follow the advice of other posters to NOT take antibiotics until it is tested to see if it a) is bacterial and b) what the proper antibiotic is. Because if it's fungal or a bacterial strain that's resistant to what you're using, you'll just make it worse.

And that does NOT look like something you want to get worse!

Hmmm... could be impetigo, or something more strange and sinister. It could be a message from gopod, a signal that you should return to civilization before you're eaten by a deviant crab. Since you're taking antibiotics and antifungals, I can only add this prescription:

1) From a new bottle of rum, pour one tablespoonful into an airtight container.

2) Carefully grasp the bottle with the remaining rum and

3) Pour the rum into your mouth and down your throat over a period of 3-5 hours.

That should cure anything.

(I'm not sure what you do with the tablespoon of rum, perhaps hair of the dawg?)

From what I gather is that you're stuck without access to good medical knowledge; not a good thing. Do you have access to pure 100% tea-tree oil? If you think it's spreading it could be a critter, or a fugus. Get some liquid soap, remove about half of it; add about a bottle cap full of tea-tree oil to the soap--a bit of water shake and stir. Use this in the bath and let it stay on you unitl you feel a tingel. Use full strength Tea tree oil after the bath on hot spots.

Dude... maybe you have the MSBlast worm!!!

You think we could get 65 signatures and $3000 to run your sore for California governor?!

When you find out what it is let us know!

Spider Bite...imho, dude

I don't care what the pharmacist says. Have it looked at by a doctor who practices medicine in that part of the world. I once ignored a sore not unlike that one, then came down with a walloping case of Lyme Disease -- and that was in the Temperate Zone. If you'd showed me that picture without giving me any further context, I'd have guessed it was a spider bite.

Tropical scrunges and rots come in a wonderful variety of forms. There are all kinds of viral and bacterial infections (some of them spread by insect bites), and recurrent funguses, and a bunch of slow-acting parasitic infestations I don't even want to think about. Get yourself checked out while you're still in the area. Don't wait until you'r back in the States, dealing with a doctor who wouldn't recognize this stuff if he saw it in a fully-labeled four-color photo insert.

I reposted Mark Frauenfelder's query to my own weblog. These are the comments thus far:

From: James D. Macdonald,
August 20, 2003 05:08 PM:

He should see a health-care professional, sooner rather than later.

Consider he has cellulitis secondary to an insect or spider bite. He needs broad-spectrum IV antibiotics.

Meanwhile, if he has oral antibiotics, take them. Elevate it (higher than his heart) to minimize swelling, and apply warm, moist compresses.

Watch for swollen lymph nodes, fever, chills, sweats, drowsiness, lethargy, blistering at the site, or red streaks extending from it. Keep track of the size of the lesion. If it isn't getting smaller, he's getting in deeper and deeper trouble.

The entire episode will probably be over in seven to ten days, one way or the other.

==================

From: David Bilek,
August 20, 2003 05:26 PM:
 
If he were in a temperate zone rather than tropical, I'd say he better get on anti-Lyme antibiotics RIGHT NOW. You Do Not Want to develop late-stage Lyme disease. Trust me.

Exactly what "tropical location" is he at? Without that information it's impossible to even guess what that bite could be. Depending on where he is, it could be a Brown Recluse bite. If so, he'll know soon enough when the entire area goes black and necrotic.

Hell, it could be topical anthrax for all we know.

If he hasn't yet seen a doctor, what is he waiting for? The leg to fall off?

==================

From: James D. Macdonald,
August 20, 2003 05:56 PM:

David is right. It's been fifteen years since I lived in the tropics, and that was the Latin American sector. There's all kinds of great stuff in Africa, Asia, wherever it's too darn hot and humid. There's no way to diagnose this over the Internet. You can't rule out spider bites, fungi, viral or bacterial infections, or parasites.

Still, elevation and warm moist heat is the general solution while going to a medic.

Any open wound in the tropics is going to get a bacterial infection sooner or later.

If I had this, I would worry.

And here's a Just For Fun: http://rob.skelly.com/index.htm

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it could be emphantiago! (may be spelled wrong)

go see a doc

Tsutsugamushi fever can sometimes cause a lesion like that. Alternatively, if it looks like there is a small white thread just below the surface of the open wound, the dracunculus worm is also a possibility. Enjoy your new exalted status as supportive culture of the food chain!

This is my first time visiting your site and i must say i like it very much.
Your post was an interesting read.
I will definetly come back here more often!
 
 
 
hooka