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I saw a patient with a blister just like that on her leg. She reported having being "bitten" by a small slow-flying insect which she described as a small black fly. The bite took place around 15:00 in the Regent's Park in London. I saw a 1" blister on this young lady's leg by 17:00 in the urgent care center.
When I saw the patient again at 18:00 the blister was three times the size, with a very tight skin. It looked like a bad burn.
I never did find out what insect it was, but the diagnosis was a local reaction to some kind of foreign matter injected or transferred to the patient by this insect.
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