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Note what signs you see.
I (W. Wertelecki, M.D.) see a progressive lymphangitis path with little evidence of cellulitis along its way.
PERSPECTIVE: This sort of linear erythema on the skin is most commonly an inflammation of a lymph channel due to an infection at some distal point. However, there also are non-bacterial causes (fungal; viral; toxic bites by spiders, etc.) Among the viral causes, herpes complex virus (HSV) is prominent and such cause should be suggested by concurrent generalized symptoms/signs. Nodular streaking with no or little concurrent cellulitis (as in this case) should suggest a fungal infection. Hypersensitivity reactions (“allergy”) to arthropod or other insect bites is suggested by coexistence of edema.
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