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Old 04-27-2015, 15:02   #1
Flagg
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Recurring Chigger rash

G'day Fellas,

I got bit pretty good by Chiggers 2.5 years ago.

I went thru the usual chigger bites and itch around my lower legs(while in Florida, wearing pants with ankle high boots, but no DEET....didn't know at the time).

Every couple of months I get a re-occurance of the same/similar non itching red spots around my lower legs as well on my inner forearms and upper arms.

This non itching rash of red dots can last from a few hours to a few days. Starts quickly and ends quickly.

It has popped up every 6 months or so the first 2 years, but recently seems to be about every 6 weeks or so.

Sand fly bites on Ex here seem to correlate with the chance of it popping up again.

------

We don't have Chiggers here in New Zealand, so I haven't knowingly been exposed to Chiggers in the last 2.5 years.

Any ideas?

Can Chigger bites result in any long-term/permanent/latent issues or allergy/immune response issues?

My GP doesn't have a clue.

Cheers for any help/advise.
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Old 04-27-2015, 15:11   #2
PedOncoDoc
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Quote:
Originally Posted by Flagg View Post
G'day Fellas,

I got bit pretty good by Chiggers 2.5 years ago.

I went thru the usual chigger bites and itch around my lower legs(while in Florida, wearing pants with ankle high boots, but no DEET....didn't know at the time).

Every couple of months I get a re-occurance of the same/similar non itching red spots around my lower legs as well on my inner forearms and upper arms.

This non itching rash of red dots can last from a few hours to a few days. Starts quickly and ends quickly.

It has popped up every 6 months or so the first 2 years, but recently seems to be about every 6 weeks or so.

Sand fly bites on Ex here seem to correlate with the chance of it popping up again.

------

We don't have Chiggers here in New Zealand, so I haven't knowingly been exposed to Chiggers in the last 2.5 years.

Any ideas?

Can Chigger bites result in any long-term/permanent/latent issues or allergy/immune response issues?

My GP doesn't have a clue.

Cheers for any help/advise.
Unlikely to be recurrent rash from prior exposure to chiggers. Can you post up a photo of the rash to give us a better opportunity to ID the potential cause? Since it's not itchy, could be something completely different.
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Old 04-27-2015, 16:55   #3
Flagg
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Unlikely to be recurrent rash from prior exposure to chiggers. Can you post up a photo of the rash to give us a better opportunity to ID the potential cause? Since it's not itchy, could be something completely different.
http://i.imgur.com/pWNUX1m.jpg

Here's a link to a photo of my left forearm.

It comes and goes away VERY quickly. Often within hours.

It seems to appear rarely(but with increasing frequency) during/after very high levels of physical exertion/stress.

To me, it looks just like the non-itching chigger rash(to me at least) around the bite sites(which I never had prior to the chigger bites).

To complicate matters, I've done a tour in Solomon Islands in 06/07 on Doxycycline in high risk malaria zone. Kenya/Tanzania on Doxycycling(Yellow Fever shot) and Cambodia with high risk malaria also on Doxycycline.

Both were before the chigger bites.

Since the chigger bites, I've done 3 tours of Afghanistan on Doxycycline in Spring/Autumn(more for poo dust and public health/flies than mozzies as fairly high/dry in Bamyan).

Cheers for any feedback.....my GP is stumped.
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Old 04-27-2015, 18:25   #4
miclo18d
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Ghonnaherpasyphilitis all the way here.

Seriously, chiggers usually get you where your clothes tighten around your body...waist line and calves where your socks ride. The "rash" (bites) is (are) usually larger bumps that are extremely itchy for about 24 hours.

There on your arm, not so much.
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Old 04-27-2015, 18:44   #5
Flagg
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Is there perhaps a certain drug taken just before the outbreak(s)?

Any sign of swollen glands before or during the rash?

Do the rash spots feel raised at all?


DDx:

Cholinergic urticaria

Miliaria crystallina

Histamine release during exercise/ elevated temp
I'm on no prescription medications, nor have I taken any over the counter meds.

No swollen glands before or after rash

Rash spots are NOT raised, nor do they itch. They appear and dissipate quickly.

If I didn't see them in the mirror, I wouldn't have even known they came and went again.
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Old 04-28-2015, 02:01   #6
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Food allergies?
Nada!

No Known Allergies.
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Old 04-28-2015, 05:16   #7
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Quote:
Originally Posted by Flagg View Post
http://i.imgur.com/pWNUX1m.jpg

Here's a link to a photo of my left forearm.

It comes and goes away VERY quickly. Often within hours.

It seems to appear rarely(but with increasing frequency) during/after very high levels of physical exertion/stress.

To me, it looks just like the non-itching chigger rash(to me at least) around the bite sites(which I never had prior to the chigger bites).

To complicate matters, I've done a tour in Solomon Islands in 06/07 on Doxycycline in high risk malaria zone. Kenya/Tanzania on Doxycycling(Yellow Fever shot) and Cambodia with high risk malaria also on Doxycycline.

Both were before the chigger bites.

Since the chigger bites, I've done 3 tours of Afghanistan on Doxycycline in Spring/Autumn(more for poo dust and public health/flies than mozzies as fairly high/dry in Bamyan).

Cheers for any feedback.....my GP is stumped.
I'd second the exercise-induced urticaria vs. cholinergic urticaria mentioned earlier given the association with exercise. The rash may be more widespread if you were to strip down and take a look. No shortness of breath/difficulty breathing or lightheadedness? Any swelling of the arms/legs?

Any family history of autoimmune disease?

If you take an antihistamine (diphenhydramine or acrivastine) prior to exercise does the rash still occur?
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Old 04-28-2015, 06:02   #8
Flagg
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I'd second the exercise-induced urticaria vs. cholinergic urticaria mentioned earlier given the association with exercise. The rash may be more widespread if you were to strip down and take a look. No shortness of breath/difficulty breathing or lightheadedness? Any swelling of the arms/legs?

Any family history of autoimmune disease?

If you take an antihistamine (diphenhydramine or acrivastine) prior to exercise does the rash still occur?
Really centred on lower legs and inside of arms. Nothing else seen, and the wife has had a good look when I've had the odd breakout.

No breathing problems or lightheartedness.

No swelling of arms/ legs, bar a wee bit foot/ankle swelling after periodic 20+ km pack walks/climbs.

Regular 8km pack walks and runs, no swelling at all.

No known history of autoimmune disease(extended family health issues have included lung cancer killing both heavy smoker maternal grandparents and lifestyle related diabetes contributing to death of paternal grandmother).

I haven't taken any antihistamines. No cold medicine(mostly just nose drops for closed nasal passages) taken in at least 18 months.
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Old 04-28-2015, 06:28   #9
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Originally Posted by Flagg View Post
Really centred on lower legs and inside of arms. Nothing else seen, and the wife has had a good look when I've had the odd breakout.

No breathing problems or lightheartedness.

No swelling of arms/ legs, bar a wee bit foot/ankle swelling after periodic 20+ km pack walks/climbs.

Regular 8km pack walks and runs, no swelling at all.

No known history of autoimmune disease(extended family health issues have included lung cancer killing both heavy smoker maternal grandparents and lifestyle related diabetes contributing to death of paternal grandmother).

I haven't taken any antihistamines. No cold medicine(mostly just nose drops for closed nasal passages) taken in at least 18 months.
The timing and duration really points to one of the two diagnoses mentioned earlier (cholinergic vs. exercise-induced urticaria).

The other possibility is exercise-induced vasculitis, but that rash typically lasts days, not minutes to hours like yours.
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Old 04-28-2015, 13:04   #10
Flagg
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Originally Posted by PedOncoDoc View Post
The timing and duration really points to one of the two diagnoses mentioned earlier (cholinergic vs. exercise-induced urticaria).

The other possibility is exercise-induced vasculitis, but that rash typically lasts days, not minutes to hours like yours.
Cheers PedOncoDoc!

Thanks heaps for your time...and the same to Brush Okie, Miclo18d, and Doc Illinois.
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Old 04-28-2015, 13:21   #11
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As always, see your doctor for actual diagnosis and treatment.

He may refer you to an allergist, if this condition exceeds his ability.

TR
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Old 04-28-2015, 16:57   #12
Flagg
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As always, see your doctor for actual diagnosis and treatment.

He may refer you to an allergist, if this condition exceeds his ability.

TR
Absolutely!

The collective wealth of knowledge here is worth tapping into to go back to my GP.

I'll be asking about allergist/immune system related specialist diagnosis.

I'm also due to go for a mole check with a dermatologist with photos of the breakout.

I don't know if it may fall somewhat under their specialisation, but at least hoping to rule it out.

Cheers!
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Old 04-28-2015, 17:00   #13
Flagg
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Correct.

NousDefionsDoc's sticky applies at all times.
Appointments being made.

Once again….cheers fellas!
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