Toe Issues: Concerns About Infections and Treatment

Toe problems (continued inquiry)

Thank you for your response, Doctor.
Regarding the first question, I still have some concerns I would like to ask.
I recently took some leftover cold medication from last week when I had a cold and visited an ENT specialist.
The medication contains antibiotics, and I noticed a red spot with an oval dark area in the middle.
Is this normal? Should I be worried about any immune-related arthritis? I have been a bit concerned after reading about it, but I only experience some itching without any joint pain, fatigue, or stiffness.

Additionally, I accidentally picked at my nail yesterday, which might have caused a small wound, and I'm unsure how it got infected.
My family keeps saying that the red spot looks like an insect bite, but can insect bites cause such issues? Also, is cellulitis really that serious? I recall seeing news reports about it being severe.
Should I seek medical attention if I experience any symptoms? It seems like the redness has decreased, but with the ongoing pandemic, I feel hesitant to go to a large hospital.
Lastly, I would like to ask if having cellulitis means I have an open wound, even if I keep it clean? Should I avoid getting it wet while showering, or is it okay to wash normally? After showering, is it safe to apply the ointment that my doctor prescribed for either paronychia or insect bites, which is fusidic acid?
P.S.
The first image shows my left foot in its normal state; I compared it and noticed that my little toe has more flesh than usual.
The second image shows the red spot.
Thank you for taking the time to respond again!

Ke, 20~29 year old female. Ask Date: 2021/01/22

Dr. Hong Yuanbin reply Internal Medicine

Hello,
1.
The black spots you described are likely the openings of hair follicles, which is a normal structure.

2.
The so-called immune-mediated arthritis mostly affects multiple joints, with the highest likelihood of a single joint being involved in gout.
However, your symptoms do not resemble gout, so it is unlikely to be an immune issue.

3.
Your cellulitis does not appear to be caused by an insect bite based on the photos you uploaded.
It may be related to onychomycosis (fungal nail infection) or tinea pedis (athlete's foot), which could be the underlying problem.
I recommend consulting a dermatologist to check for onychomycosis or tinea pedis.

4.
Typically, small wounds can lead to this issue.
It is advisable not to rub the wound vigorously; regular bathing should not cause any significant impact.

5.
Fusidic acid is an antibiotic ointment that can be used.

Thank you for your inquiry.

Reply Date: 2021/01/22

More Info

When it comes to toe issues, particularly concerning infections and potential complications like cellulitis, it's essential to understand the symptoms and appropriate responses. Based on your description, it seems you have a red spot on your toe that has raised some concerns, especially regarding the possibility of an infection or other underlying issues.

Firstly, the presence of a red spot on your toe could be due to several reasons, including a bug bite, an infection, or even a reaction to a minor injury. The fact that you mentioned it is somewhat itchy but not accompanied by joint pain, fatigue, or stiffness is a positive sign. These symptoms could indicate that your immune system is functioning well, as systemic symptoms like joint pain and fatigue often accompany more severe infections or autoimmune conditions.

Regarding your concern about cellulitis, it is indeed a serious condition that occurs when bacteria enter the skin through a break or crack. Symptoms typically include redness, swelling, warmth, and pain in the affected area. If you notice any of these symptoms worsening, such as increased redness, swelling, or if you develop fever, it would be prudent to seek medical attention promptly.
You mentioned that your family thinks the red spot looks like a bug bite. Insect bites can cause localized redness and swelling, and they can sometimes become infected if scratched or if bacteria enter through the skin. If you have been scratching the area, this could explain the irritation and potential for infection.
As for your question about cleanliness and the risk of cellulitis, maintaining good hygiene is crucial. However, the presence of cellulitis does not necessarily mean you have an open wound; it can occur with minor skin breaks that may not be immediately visible. When it comes to bathing, it is generally safe to wash the area with mild soap and water. Avoid soaking the affected toe in water for prolonged periods, as this can exacerbate any irritation. After washing, gently pat the area dry and consider applying the fusidic acid ointment as prescribed by your doctor. This antibiotic ointment can help prevent or treat any bacterial infection.

If you notice that the red spot is not improving or if it starts to spread, it would be wise to consult a healthcare professional. They may recommend further evaluation, including a physical examination and possibly imaging studies if they suspect a deeper infection.
In summary, while your symptoms do not currently suggest a severe issue, it is essential to monitor the situation closely. If you experience any worsening symptoms or new developments, do not hesitate to seek medical advice. Keeping the area clean, applying prescribed treatments, and being aware of any changes will help you manage the situation effectively.

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