Dear Sir, A 34-year-old female health care assistant presented with a 1 week history of gradual onset of swelling and redness of her right hand. The patient gave a vague history of an insect bite on the flexor surface of her wrist. She was afebrile. There was gross global swelling of the whole of her right hand with mild erythema (Fig 1). There were no signs of any injury or insect bite marks. Palpation revealed local warmth and mild tenderness over the whole hand. There were no signs suggestive of flexor sheath infection or compartment syndrome. Plain radiographs of the hand and blood tests were unremarkable.
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