Skin Issues: Red Spots and Symptoms Explained

Doctor, I would like to ask you?

I started developing small red spots on my hands and feet last week, which look like mosquito bites, and they have been increasing in number.
Now, there are some red spots on my hands that have small pustules.
I have been taking oral medication, but the red spots keep appearing.
I have also started to experience a fever, headache (I feel dizzy when walking), nausea, and my body feels very hot.
What could be the problem?

Xiao Pang Pang, 10~19 year old female. Ask Date: 2011/10/16

Dr. Wu Yuxin reply Dermatology

If you are certain that you have been bitten by an insect and have developed pustules along with systemic symptoms such as fever, it is likely an infection or a severe allergic reaction.
Please seek medical attention promptly to avoid any delay in treatment.
Wishing you a speedy recovery.

Reply Date: 2011/10/16

More Info

It sounds like you are experiencing a concerning skin condition that has progressed over the past week, with the appearance of red spots on your hands and feet, some of which have developed into small pustules. Additionally, you are experiencing systemic symptoms such as fever, headache, dizziness, and nausea. Given these symptoms, it is crucial to seek medical attention promptly, as they may indicate a more serious underlying condition.

Based on your description, several potential diagnoses could be considered. One possibility is an allergic reaction or contact dermatitis, which can cause red, itchy spots on the skin. This could be triggered by exposure to a new substance, such as a skincare product, detergent, or even food. However, the presence of pustules and systemic symptoms like fever and malaise suggests that it could be more than just a localized allergic reaction.

Another possibility is an infectious process, such as a viral or bacterial infection. Conditions like chickenpox or hand, foot, and mouth disease can present with red spots and systemic symptoms, especially in younger individuals. Bacterial infections, such as impetigo, can also cause red spots and pustules, often accompanied by fever and malaise.

Autoimmune conditions, such as vasculitis or other systemic diseases, could also manifest with skin symptoms and systemic involvement. Conditions like lupus or dermatomyositis can cause skin rashes and systemic symptoms, but these are typically diagnosed through specific blood tests and clinical evaluation.

Given the combination of skin symptoms and systemic signs like fever and dizziness, it is essential to consult a healthcare provider as soon as possible. They will likely perform a thorough physical examination, take a detailed medical history, and may order laboratory tests, including blood tests and possibly a skin biopsy, to determine the underlying cause of your symptoms.

In the meantime, here are some general recommendations to help manage your symptoms until you can see a doctor:
1. Avoid Scratching: Try not to scratch the affected areas, as this can lead to further irritation or secondary infections.

2. Cool Compresses: Applying cool, damp cloths to the affected areas may help soothe irritation and reduce redness.

3. Over-the-Counter Antihistamines: If you suspect an allergic reaction, taking an antihistamine like diphenhydramine (Benadryl) may help alleviate itching and redness.

4. Hydration: Ensure you stay well-hydrated, especially if you are experiencing fever and nausea.

5. Monitor Symptoms: Keep track of any changes in your symptoms, including the development of new spots, changes in fever, or worsening of systemic symptoms.

6. Avoid New Products: Refrain from using any new skincare products or medications until you have consulted with a healthcare provider.

In conclusion, while it is difficult to provide a specific diagnosis without a physical examination and appropriate testing, your symptoms warrant immediate medical attention. Please prioritize seeing a healthcare professional to receive an accurate diagnosis and appropriate treatment.

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