Red Bumps on Hands

[jcule]

While traveling abroad, my girlfriend and I both found several small red bumps on the top of our hands. Hers went away quickly, while mine slowly spread. Doctors there gave me cortisone injections, allergy medication, and steroid cream to treat the bumps. Four days later they had spread on my right hand and I also had some bumps or red marks on my face, ears, and chest. We were staying in hotels together, and at a friend's place in this time. The bumps were mildly itchy, small, and some (those on my hands) had that glossy top look. Before returning home (after four days of symptoms), my girlfriend's symptoms returned all over her body. She also had flue symptoms, which could have been unrelated. She did not travel back with me and her symptoms eventually dissipated after a few weeks.

As for me, I came home and saw two dermatologists. The first said it was scabies after an oh so brief examination. He treated me with permethrin. The second doctor ruled out scabies immediately, saying it was some other parasite or bug bite. He treated me with ivermectin. I took ivermectin twice over a three week period. After both treatments, I saw improvement in my condition, only to have it return after four days or so. The second doctor then ruled out parasites, and said I should get my place checked for bed bugs. Meanwhile, red bumps have persisted on my hands (particularly the right hand), and less so anywhere else. I've had one or two bumps appear and go away on my torso, legs, and forearms. in general, they seem to come and go.. occassionally reappearing in the exact same places they were before, like one red mark on the palm of my left hand. The exterminator company I hired brought a sniffing dog, which sensed bed bugs in the couch and rug. I threw away both and have been treating the apartment, but remain skeptical with this diagnosis. Does this sound like bed bug bites? Do symptoms from bed bug bites sometimes take time to appear?

Any ideas what this might be? Many thanks.

[jcule]

Dear Dr. Kaur, Thank you for your kind reply. Since I wrote this post, and after at least five weeks of symptoms, the marks/bites/bumps on my hands are now suddenly dissipating at a slow rate. As I  understand, this would rule out the possibility of scabies. It's possible the measures I took in my apartment to combat bed bugs had their effect, though I have not found any signs of their presence whatsoever (and I searched thoroughly and carefully). Given that I took Ivermectin to kill any parasites and it didn't produce results, is there anything other than parasites or bed bugs that may have caused this? I'm still fearful that my symptoms will return. Thank you again for your help.  

[Bhupinder Kaur, MD]

Hello,
From your symptoms the chances of scabies are high rather than bed bug bites. It is an infestation of the skin with the Sarcoptes scabiei mite and is a highly contagious disease. Since your girlfriend had similar symptoms so definitely this gives this possibility an edge. It is characterized by intense itching, usually at night and by small insect-type bites lesions on the skin. Diagnosis of scabies is made by scraping the skin and viewing the material under a microscope to see the characteristic mite or eggs.

So my advice would be to consult a dermatologist and get this investigation done to rule out/ confirm scabies. It is very difficult to precisely confirm a diagnosis without examination and investigations and the answer is based on the medical information provided. For exact diagnosis, you are requested to consult your dermatologist. I sincerely hope that helps. Take care and please do keep me posted on how you are doing.