#Skin Abscess

[creativeera]

Acute Bacterial Skin And Skin Structure Infections Market Trends driven by Increasing Antibiotic Resistance

The acute bacterial skin and skin structure infections (ABSSSI) market comprises anti-infective drugs that are used to treat skin infections caused by bacteria. These infections include impetigo, cellulitis, wound infections, and major cutaneous abscesses. The commonly prescribed drugs are antibiotics such as cephalosporins, carbapenems, lipoglycopeptides, oxazolidinones, and tetracyclines. The increasing threat of antimicrobial resistance (AMR) has boosted the demand for effective antibiotic treatments. Growing prevalence of skin infections owing to rising environmental pollution levels and lifestyle changes has also augmented market growth.

Global acute bacterial skin and skin structure infections market is estimated to be valued at USD 3,842.5 Mn in 2024 and is expected to reach USD 5,701.7 Mn by 2031, exhibiting a compound annual growth rate (CAGR) of 5.8% from 2024 to 2031.

Key Takeaways Key players operating in the Acute Bacterial Skin And Skin Structure Infections market are Fresenius SE and Co. KGaA, Pfizer, Inc., Amneal Pharmaceuticals LLC, Intas Pharmaceuticals Ltd., Cadila Healthcare Ltd., Glenmark Pharmaceuticals Ltd, GSK plc, Sun Pharmaceutical Industries Ltd., Aurobindo Pharma Ltd., AbbVie, Inc., Melinta Therapeutics LLC, Accord Healthcare Ltd., Merck and Co., Inc., Teva Pharmaceutical Industries Ltd., Paratek Pharmaceuticals, Inc. The growing prevalence of skin infections across the world coupled with the rising threat of AMR is fueling the demand for effective antibiotic therapies. Leading market players are investing in R&D to develop novel drugs with new mechanisms of action. On the other hand, companies are also undertaking initiatives to expand their presence in emerging economies through strategic partnerships and acquisition activities. The Acute Bacterial Skin And Skin Structure Infections Market Demand rising threat of antimicrobial resistance is a key concern that is augmenting the demand for novel and effective anti-infective treatments for ABSSSIs. According to the WHO, drug-resistant bacteria could cause 10 million deaths annually by 2050 if adequate actions are not taken. Growing awareness regarding antibiotic stewardship practices is reducing the irrational use of antibiotics to some extent. However, further regulatory interventions and strict prescribing guidelines are required to curb the development and spread of resistant pathogens. Market Key Trends One of the major trends witnessed in the acute bacterial skin and skin structure infections market is the rising focus on developing new antibiotic classes with novel mechanisms of action to overcome anti-microbial resistance. Several pipeline drugs under clinical trials employ new mechanisms like inhibition of bacterial DNA/RNA synthesis, cell wall biosynthesis, and protein synthesis. Monoclonal antibodies targeting specific toxins produced by resistant bacteria is another novel area being explored. Fast track approvals and commercialization of path-breaking antibiotic therapies will ensure long-term market sustenance amid growing healthcare costs and stringent pricing control by governments globally.

Porter's Analysis Threat of new entrants: New players find it difficult to enter this market owing to high costs of R&D and regulatory requirements. Bargaining power of buyers: Many buyers have low bargaining power due to lack of alternatives. Bargaining power of suppliers: Suppliers have moderate bargaining power due to availability of substitute sources. Threat of new substitutes: Threat from new substitutes is moderate due to technology developments and increasing investments in alternatives. Competitive rivalry: Fierce competition exists among existing players to gain market share. Geographical Regions North America accounts for the largest share of the global acute bacterial skin and skin structure infections market, in terms of value, followed by Europe. This is attributed to the rapidly growing incidence of skin infections, advanced healthcare infrastructure, favorable reimbursement policies, and high awareness among healthcare professionals and patients regarding diagnosis and treatment. Asia Pacific is expected to witness the fastest growth during the forecast period, primarily driven by improving access to healthcare facilities owing to rising disposable incomes, growing incidence of skin infections due to changing lifestyles, and supportive government policies and initiatives in emerging economies. Rising medical tourism in Asian countries has also boosted the market growth in the region.

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Vaagisha brings over three years of expertise as a content editor in the market research domain. Originally a creative writer, she discovered her passion for editing, combining her flair for writing with a meticulous eye for detail. Her ability to craft and refine compelling content makes her an invaluable asset in delivering polished and engaging write-ups.

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[forestofsprites]

soooo the thing is <3 i did find and also start a rowena portrait, BUT ! then i found a photo of rachel miner with ruth connell. and you know how i've been having endless rowena & meg. megena. roweg. thoughts as of late......

[tangledinink]

... the fuck you mean you've had too many teeth broski.

OH well when I was like eight I had an extra tooth that was trying to grow upwards, like, into my nose, so they had to go in and surgically remove that one. smh. it fucked up all my other teeth somehow so then i got braces immediately after. i have really good mouth genetics actually.

[tilda-rothery]

I recently had surgery on my leg – like last Tuesday – to remove necrotic tissue from a skin infection turned into a really bad abscess. Now I've had skin infections and abscesses before, I'm unbelievably prone to them, no matter how clean or careful I am. I do believe there must be an underlying cause, I just haven't found it yet. But I've never in my life, had one like this.

It turned very quickly, from barely any redness or pain on Saturday, to me saying on Sunday 'tomorrow I'm going to book in to see the GP before this gets bad', to me crying on Monday evening on the phone to 111 (UK out of hours) because a very small area of the infection site had started to turn black, which then had me going to A&E later Monday evening (11pm).

I was in excruciating pain before surgery, so much so that even the dose of codeine they gave me in A&E (for which I sat for 7 hours) did nothing to elevate my discomfort.

Within 5 minutes of seeing my leg, (after sitting there for the aforementioned 7 hours), I was seen by two surgeons and placed immediately on a drip of antibiotics - and yes I had managed to see my local GP as soon as was possible on Monday morning and had already started a strong course of antibiotics before going to A&E later that day/evening. The GP decided not to drain it then and there because when I saw him Monday morning, the infection wasn't even half as bad as what it was Monday evening.

I had a special visit from the head of surgery, as well my primary surgeons and a junior anaesthetist all between the hours of 6.30-9am on Tuesday.

I was in theatre by 9.15am. This marks my first ever surgery. I was under general anaesthetic. The surgeons did not know the extent of the damage the infection had done to my leg.

By 10.15am a good chunk of my thigh had been removed but the pain was completely gone! Partly due to the removal of all the bad shit that had accumulated in my leg and partly due to the drugs.

I was sent home late Wednesday, armed with pain meds and more antibiotics.

I am currently undergoing daily visitations from my district nurses because the surgeons decided that for optimal healing, and to avoid repeat infections, to leave my abscess cavity open - no stitches, just a gaping hole in my thigh.

Everyday the nurses have to pack my leg with surgical ribbon and apply a dressing.

Yesterday was the first time in a week that I felt brave enough to take a photo and actually look at my wound. Honestly, it's both extremely gross, yet truly fascinating. It measures 4.9cm in length and 2cm in width. They have yet to measure the depth.

You can see a small amount of the muscle in my leg, it is completely exposed. What's even more fascinating is that today when I mentioned that I could actually see my muscle to the nurse, she said that if I moved, she'd be able to see it twitch. I mean of course she would, but the thought never occurred to me that anyone would ever be able to watch my thigh muscle move from within my body.

I now have to be extra careful to make sure my wound is kept clean and covered for the next who knows how long (the nurses reckon a month, I am unable to work during this time) while it heals so that it doesn't get infected, especially now as my course of antibiotics has finished.

I now find myself with far too much free time on my hands now that I am homebound.... Lots of TV (good thing there are 20 seasons of Greys Anatomy, not that I managed to get past season 13 on my last watch), Stardew valley and a little bit of crochet to occupy my time with.

To say I am starting to get a little bored is an understatement.

And now I have rambled!

So, moral of the story, be extra careful with skin infections, they can take a turn for the absolute worst within a blink of an eye, regardless of if you've done absolutely everything you can think of to prevent further infection.

They are no joke.

[ajokeformur-ray]

Has anyone had paronychia before? I’m worried I’m gonna lose my toe. Like, genuinely worried. I’ve been on antibiotics for two days and it’s not improving, it’s getting worse and I’m scared.

[natjennie]

hs is bad :(

[butchyena]

making myself sick w paranoia lol i have like 3 weeks before i see my doctor again and she didn’t SAY anything alluding to it but im so so convinced the last abscess left isnt draining fast enough and shes gonna want to do surgery for the fourth time

[barklikeagod]

like it’s $181 just for visiting the vet in general like not including medicine and any kind of surgical procedure. i’m going to off myself actually

[2024skin]

My unfeminist trait is that when healthcare workers tell stories about how they wore makeup to work and then some type of patient excrement got stuck to it, that makes me really happy

[siryaoimaster]

need to stop biting my nails so much

[beefcakekinard]

They climb into Tommy's truck, their doors slamming shut one after another. Tommy reaches for the ignition but Evan's hand on his forearm stops him. He looks to his right, to Evan, who looks back at him with a smile like the sunlight dappled by leaves just earlier.

"Thank you," Evan says. Tommy looks into his eyes. Only his eyes. Nowhere else.

"You're welcome," he says; he places his hand on top of Evan's and squeezes. "Do you feel better?"

Evan scrunches up his face. It does... interesting... things to the abscesses spattered across his skin. "Emotionally, yeah. Physically, though..."

"Hmm." Tommy leans across the centre console and pecks his lips against Evan's. A sore grazes the side of his nose. Tommy can't hold back the full-body shudder that rolls through him.

Evan groans and pushes Tommy back by a hand in his face. Tommy grins, grabs Evan's hand, kisses his knuckles, and prays this curse is over.

[certifiedsexed]

You know what genital condition hurts worse than anything else I've ever experienced, and I'd never encountered at all before I developed one?

A Bartholin abscess. I feel like it's important for people to know about them; they're painful, debilitating, misunderstood, and often dismissed by non-specialist doctors as 'going away by themselves'. The gynecologist I saw with my most recent one said she treats 20+ of them a week, but nobody talks about them. There certainly weren't any clinic posters talking about them. Plenty about STIs and pap smears, but no Bartholin awareness.

I would encourage anyone who's factory plumbing came with a vagina, or who cares about someone with that plumbing, to put Safesearch or the search engine equivalent on (because the images that pop up are the worst case scenario, and also NSFW if you're at school/in the office) and look into Bartholin cysts and the abscesses that come from them. The wiki page is a good starting point.

If you notice a lump near the opening of your vagina, get medical help. Don't wait and see if it goes away. My first one I was so depressed that I just pretended it wasn't there, and it went from the size of a grain of rice to the size of a peach in under a week. Imagine something the size of a peach under the skin of your inner labia.

These abscesses do eventually rupture and drain, which stops them hurting somewhat though they still have to heal, but until then the sheer size and painfulness impedes walking, sitting, using the toilet, cleaning after using the toilet, and just about everything else. The pain I had was extraordinary and entirely debilitating, I can't understate that. It's an area with a lot of nerve endings and very good blood flow, you know?

The second one I had I started treatment with Flucloxacillin on day two and it didn't get anywhere near as big or as painful. It still hurt a little, got to about the size of a grape, and still popped after about ten days, but I was able to continue working and mostly get along as normal.

I've been told that once you've had one they're likely to come back unless you get medical intervention so it really is key to not ignore them.

Sorry to be hijacking, I know this isn't entirely about sex ed as such, but like... I went to a school in a liberal area with fairly comprehensive sex ed which included frank and open discussions around health and diseases, and I've been around on the internet for a decade since as well, and had never heard of these until I developed one. I'm still recovering from the most recent episode, and really do not want anyone else to sprout one of these and have no idea what's happening or be dismissed by a doctor and not have the knowledge to advocate for themselves.

I don't think this is hijacking at all. I think this' great information to share, thank you! [This is an article about Bartholin cysts/abscesses, for anyone interested.]

[literaryvein-reblogs]

Writing Notes: Wound Care

Wound care - involves cleaning a wound, flushing or irrigating it with pressurized water or an antiseptic solution, and applying or changing a dressing.

Immediate Wound Care

Applying direct pressure to control any bleeding

Examining the wound for dirt and foreign objects after any bleeding has stopped

Cleaning the wound by gently flooding it with saline solution if available, with bottled water, or with clean running water

Gently cleansing the area around the wound with soap and clean water

Patting the area dry and covering it with an adhesive bandage or clean dry cloth

Leaving uncovered bites, punctures, and wounds that cannot be properly cleaned to prevent trapping bacteria that could result in infection

Aftercare

Aimed at preventing infection.

Puncture wounds or contaminated wounds may require a tetanus booster shot.

Dressings should never be reused.

Any soiled laundry from wound care procedures should be washed separately from other laundry, possibly with bleach.

Sometimes a wound-drainage culture is used to test for bacteria, fungi, or viruses in open wounds from punctures, cuts, tears, or surgical incisions or abscesses.

Abscesses require making a small incision in the skin to obtain pus or fluid from the wound.

The tip of a sterile cotton swab or a syringe and small needle (needle aspiration) is used to remove the sample for culturing.

Some Terminology

Aerobe—Bacteria that require oxygen to live.

Alginate—Colloidal substances from marine brown algae, especially giant kelp, that are used for wound dressings.

Anaerobe—Bacteria that live only where there is no oxygen.

Antiseptic—Chemicals applied to the skin to destroy bacteria and prevent infection.

Autolytic—Self-digestion; breakdown of tissue by the body’s own enzymes.

Debridement—The removal of cut, dead, or contaminated tissue.

Dehiscence—The opening of sutures from a surgical incision.

Dressing—The covering of a wound.

Exudate—Drainage from a wound; an exudative wound is one that drains fluid and pus.

Hydrocolloid—Dressing material that turns into a gel when combined with watery drainage.

Hydrogel—A water-based dressing material.

Hydrophilic—Dressing material that absorbs water.

Irrigation—Flushing or washing out a wound.

Necrotic—Dead tissue.

Normal flora—The mixture of bacteria normally found at specific body sites.

Normal saline—Physiological saline; a solution of 0.9% sodium chloride, the approximate salt concentrate of blood and tissues.

Tetanus—Lockjaw; a rare but often fatal infection caused by the bacterium Clostridium tetani that lives in soil, dust, and manure.

Source ⚜ More: Writing Notes & References More: Writing Realistic Injuries ⚜ On Anatomy ⚜ On Wounds

[gladiatorcunt]

I want to be non conned by Anakin ☹️

the first time i saw this ask, i was eating chicken nuggets (safe food moment) and was like "damn me too 😔." (obvious tw non con, choking, canon sw universe ani, delusional and obsessive behavior, forced pregnancy/baby trapping, reader has a pussy, use of the word “wife” in a gender roles way and “pillow princess”)

anakin can do nearly every variation and flavor of non con imo, his canon character allows for a lot of flexibility in that area. there's the soft and sweet gentle non con where he's smoothing his hands up and down your back as his thrusts bury you in the sheets. he's not crying, just a little teary because it feels so good and maybe you'll finally listen to him about how the two of you are meant to be together. that's very aotc anakin coded to me, not that rots!anakin couldn't do it like that in the right circumstances (and how you behave and react to certain situations).

for example in the beginning of aotc, and you're another padawan who's formed an unnatural bond with ani over the years. he's anxious to be knighted and you can tell that his mood is dampening more and more every day. all he says is that he has trouble sleeping, nightmares and obi-wans' karking loud snoring. you giggle and fall for the misdirection, tugging him over to the sparring mat. the next time you meet, you hear more about padmé and their history. he's being assigned to protect her so he can't be your training partner for the time being.

it's noble, of course, it's unbecoming of a jedi to be anything other than happy to see anakin follow the path you always knew he could. he has a light in his eyes you haven't seen in weeks and you attribute that to a person rather than considering the possibility that he's happy because he finally has a purpose. but you're 20 years old, being a (hopefully) future jedi master doesn't grant you any extra wisdom when it comes to love. you don't think much of pulling away, ani is going to have his hands full (of what you refuse to think further on) and you should start sorting out your priorities.

you've just made the biggest mistake of your life. outside the room where the senator is peacefully slumbering away, anakin can't stop overthinking and wondering what he did wrong. why haven't you been answering his messages, he's told you so many times that he could fix your holopad for you. he's so deep in thought that he barely makes it in time to terminate the insects deployed to poison padmé and chase after the assassin. he doesn't know that this time apart has allowed you to have an epiphany, and that you'll be gone by the time he comes back from naboo. perhaps there was more to the galaxy than being a jedi.

he tracks you down after his mother dies, feeling adrift without you and high off the adrenaline of indulging the darker parts of his soul. he wouldn't even have known you were leaving had it not been for a concerned message from obi-wan. you didn't even leave coruscant, you wandered down into the lower levels like you were waiting to die. well you don't get to do that without him, so he pins you down on the sorry excuse for a bed you've bought yourself and tells you that this must be what it feels like to make love. your tears mingle as you kiss slowly and flames lick at his back as you drag your hands down his flesh. he murmurs that it's okay, he can't lose you too and he knows just what to do, plenty of couples in the galaxy settle down young. he'd never abandon you, to leave behind what he has allowed to grow into his skin like an abscess is aberrant to the core of anakin's very being.

your pussy parts like the petals of a flower as he pushes his leaky cock into you, and it's so beautiful with his cum seeping out that he knows the force incarnate is between your thighs. you're still sniffling, and your nipples feel bitten to shreds, and that's alright. marriage day jitters are normal, he can only imagine how much more you'll glow when you have a piece or two of the force's son growing in your womb. he blushes and stammers when he asks you to keep his cum in and not touch yourself while he's gone, excited at the prospect of playing husband and wife until the mission is over and you can have a real wedding.

you tell yourself that you hated what your best friend did to you, but you keep your hand away from your begging cunt and smother yourself with the spare cloak he left behind. in a way, desire pools in your gut at the thought that you have to be forced to come out of your shell. you know anakin has grown up too hungry to hate fighting for his meal, and he has done enough proving himself. the flecks of blood matting the hair at the nape of his neck flashes through your mind as you grind your hips up against nothing. his movements were awkward at the first, but his sheer determination and passion had your brain leaking out of your ears by the end.

you remember feeling his dick twitch when you tensed, and he thought that you would attempt to fight but you only moaned and kept his head tucked away in the crook of your shoulder. the force radiated of embarrassed satisfaction that grew more confident with every squeak and groan. he liked seeing the fight drain out of your eyes more than the idea of you actually following through on it. your soresu never quite matched up to his anyway.

then there's the harder version. you resist more in whatever scenario and you delude yourself into thinking that anakin is the kind of dog that would throw away the bone he's chomping down on when he's bored of it. he manhandles you and tosses you around the room, shoving his cock up to the hilt and snarling at you to know who is doing this to you and love him anyway. your snot slides down the wall and your face is smushed against the peeling paint, blood drips down his length when he pulls out and he actually pouts in disappointment when he misses a few drops as he scoops it up with his fingers and takes them into his mouth. you're dizzy as he chokes you, your head spins when he spanks you while forcing you to ride his face. you will stare down the lightsaber handle of his devotion and push the button without hesitation.

you'd likely end up pregnant and waiting on your jedi husband to fall from one pedestal after the other. but the one reserved for the man of the house is guarded by you and your children, he bends over the gilded railing and kisses the breath out of your lungs. even when that pedestal drips with tar and becomes an ominous throne. this is a story that happened so long ago after all, nothing can be done to alter events that have already come to pass.

BUT ANYWAY, his prosthetic arm would also be a big focus in non con. no matter how hard he's ruining you or beating your body up, there will always be undeniable and inevitable love in it for anakin. punishments involving impact are dulled down and reduced to only his flesh hand. even in the gentler non con situations, he's so careful and aware of where his mechanical arm is at all times and what it's doing. there is no bruise he wants to give you when you did not deserve them, he offers it as a cooling balm of sorts to your heated skin in the aftermath. he likes to watch you lather the metal digits in spit as you suckle while you come down from your forced high, sometimes he swears he can feel the ridges of your tongue slide along the smooth surface.

he's so in love.

even with non con, i actually don't see anakin being all that verbal right after he cums. he'll have to calm down a bit before he can start speaking. but he'll silently nuzzle you and caress the spots on your body you wouldn't really think about, like the side of your sore tit and right on the plush flesh above your left hip bone. very touch you know and if you're able to pick up on it i imagine he would send out calming energy and just pure love into the force. but it's so intense you think you can see the smoke vapors rising up from your skin. visions of the future are shared between you, as well as eventual whispered promises of you being the crown jewel of his new empire. imagine the elaborate nurseries, putting the children to bed and then getting countless orgasms as thanks for being the best wife and parent in the galaxy. but he's sure to remind you that no one would ever love you more than anakin, even your children.

and i don't see him dipping into non con somno much other than the initial tease to your wet cunt and inserting his hard cock into your hole. the slow creep into your room, the creak of your bed as he settles his weight down, the soft woosh of the blanket being pulled off your gorgeous body. he'd want you to wake up and thrash around for a few seconds before giving in to how good he knows he's making you feel. because he knows perfectly well he could send out suggestions into the force that you put you deeply asleep and without chance of ever waking up until he wants you to. but your genuine reactions are so cute, playing with his soulmate is only fun if you can actively participate.

whether that be by crying or humping him desperately or clawing trenches down his back or riding him on the rare occasion your hormones have overpowered your pillow princess tendencies.

also this isn't non con related but in terms of love languages: other than physical touch, i think words of affirmation is a big one for him. actually being verbally reassured and given sweet nothings of his own to tuck away between his robes for him to focus on as he cuts down any threat to your eternal happiness. being told that he is worthy of love and that he's an incredible jedi, i think just being told that you're proud of him and that he hasn't spent years trying to be somebody to someone for nothing. blah blah he internalizes so much that it would help him to be given an opportunity to express those feelings blah etc etc and having you validate him would render his need to be on the council largely useless etc.

(he would unironically kill to be your alpha in an a/b/o setting i fear)

[impale-me-radio-daddy]

Could you do a Lookalike reader getting his hooves or ears brushed / cleaned by Alastor in a similar vein to the antler one? Maybe a standalone mini series of 'Parts I wanted to include in the main series but couldn't find space for it.'

I would be so up for that.

Hey man, thanks for the ask! I think I went a bit off-topic here, but I still think it's hot so I'm gonna post it. I've put a line for the more squeamish readers to stop at. Caveat emptor and all that.

Pairing: Alastor X reader

Wordcount: 2.2k

Warnings: they/them pronouns, reader is a hermaphrodite, Foot stuff, Hoof stuff, scent glands, DEER THINGS, slight sexual content, Alastor being fucking weird

You didn’t know what was wrong with you at first. You’d held a variety of jobs during your mortal life, but vet wasn’t one of them. What you knew about medicine you knew from backwoods surgery, and what you knew about deer physiology was limited to the things that made their meat unsafe for consumption, the telltale lesions and growths on a carcass that meant it got burned or buried rather than butchered. This wasn’t one of those things.

There was a hard lump on the front of your leg, above where the keratin of your two standing nails ended and below the level of your dewclaws, close to the webbing of skin where your two toes joined. On a human this would have been the shin, but for you it felt more like your tarsal.

It had been small at first, and you had ignored it. Then it had grown larger, painful as it had rubbed against the tongue of your boot. Today you had limped your way through your shift at the hotel, your smile more of a grimace than anything that could genuinely be describes as cheerful, and retreated to the room you shared with Alastor as soon as your contract no longer compelled you to work.

Now you lay in the four-footed bathtub in Alastor’s ensuite bathroom, examining your hoof more thoroughly. Was this an abscess? Did you need to lance it? Your skin graded to a dark grey towards your red nails, so it was difficult to gauge the lump’s condition from color as it would be on a paler part of you. You were pushing at the lump with your fingers, feeling the heat of inflamed flesh when Alastor materialized from the shadows at the bathroom door, his eyes narrowed with suspicion.

“What are you doing here?”

You hadn’t expected him to return to the room for hours, and even then, he generally gave you privacy when you were cleaning yourself. Fear shot through you like a cold wave in your stomach, the feeling of being caught, and you fought the reflex to hide your leg from Alastor. Your career as a serial killer would have been short-lived if you weren’t able to hide guilt, after all. “Do you mind?” you said, broadcasting annoyance.

Alastor looked unimpressed, taking a step closer. “I asked you a question,” he said.

“I would think it’s fairly apparent, but right now I was thinking of cutting my nails,” you lied, smoothly. “What are you doing here?”

“Why, looking for you,” said Alastor, his gaze settling on the red tips of your hooves. “I was about to cook dinner for everyone, and I could do with a sous chef who doesn’t try to boil themselves every time I set a pot of water on the heat or drink all the wine before it goes in the sauce.” He moved closer, arms behind his back. “Though I suppose those are getting rather long,” he said, eyes still on your standing nails, the two red points on the end of each of your hooves. “Let me help you with that.”

“No, I couldn’t put you out,” you raised a hand in protest, but Alastor was already in the space with you, bending to fetch a pedicure kit full of small knives, curved clippers and different grades of files from the cupboard that stood next to the basin.

“Nonsense, my dear, pure nonsense.” Alastor took a seat on the painted metal stool that lived next to the tub and looked down at you, teeth gleaming. “I hope you don’t mean to say I’m not up to the task.”

“Of course not,” you frowned, and Alastor clicked his tongue in disapproval as he took your good leg in his hand.

Disapproval at your facial expression did nothing to stop Alastor’s roving hands, however, the hand that was holding your leg stroking down the arch of your foot to the pads beneath as he fetched a pair of clippers from the box at his feet. The touch was pleasant, and deliberate, and the clippers resembled a pair of secateurs more than anything else, the sort that could easily remove a thumb if applied correctly.

“If you cut to here-” Alastor took your hand, pulling it to the pad of your hoof, where the flesh was attached to the backside of the nail, and traced a line, dragging your finger alongside his. “-the hoof will be too short, and you’ll injure yourself walking-” You listened carefully as Alastor talked, moving your fingers over your hoof so that you would know his instructions by touch. It would have been a relaxing, bonding activity, if it weren’t for the aching lump on your leg, and your growing anxiety at it being discovered. Alastor’s hands were gentle on the pads beneath your hooves, holding your leg perfectly steady as he made each cut.

He moved to your other leg, and you were sure he would notice the lump, but he said nothing, either ignorant or letting you stew in your own embarrassment as you lay in the warm bathwater, his skilled fingers squeezing the arch of your hoof, thumb brushing against your dewclaws as he repeated the process, leaving you enough length in your nail that you would be able to walk comfortably. Sweeping the red slivers of your hooves aside, Alastor took a pair of files from the box, one coarse, one fine, and you felt the vibrations through the nail and through the bones of your leg as he filed down the rough edges. He did it slowly, watching your face as he drew the file back and forth with a gradual movement, the sensation something like a shiver as the metal abraded the surface. When he was done, he ran a thumb over each edge, feeling for imperfections.

Alastor brushed away the fine pink dust with his hand and smiled at his handiwork. “There. That’s better, don’t you agree?”

You nodded, something like relief flooding through you when Alastor hadn’t addressed the problem. You were free to deal with it. Privately.

[nb: if you just wanted hoof clipping, stop reading here]

“And it’s high time we did something about that,” said Alastor, gaze sliding over your bad leg, and your sense of relief shattered. “After all, you didn’t really think there was any part of yourself that you could keep a secret from me, did you?” Alastor’s smile turned cruel, his finger tracing a gentle line up between the two toes of your cloven hoof to the lump, even the light pressure he applied excruciating, and you held your breath to not cry out. “You were limping, darling,” he continued, voice chiding. “I was worried.”

You blinked away tears of pain, studying Alastor’s expression. Really, you’d been embarrassed more than anything- the horror that the strange lump might be due to a failure of basic hygiene on your part, but the way that Alastor examined it without surprise told you that it was an issue he was at least familiar with. Maybe something he’d dealt with on his own body, in his early days in Hell.

“You know what it is?” you asked.

Alastor hummed, his fingers trailing down the freshly pedicured red keratin of your nails and round to the soft pads of flesh that sat behind them, pressing and probing. Oh, that felt nice. “You’ve field dressed a deer before,” he said, chiding. “You really should know this yourself.”

You sank a little deeper into the bath, pouting. “I was a hunter, not a veterinarian. I cut the hooves off before skinning. Dried them sometimes.”

“And I thought you were a curious person.” Alastor smiled to himself, seeming to enjoy having such an advantage over you. “But I suppose I should educate you.” His fingers ceased their massage of your spongy underfoot, and he parted your toes, his touch on the web of skin where the two of them joined. “You have a scent gland here,” he said, pressing his finger against a narrow vertical slit on your dark skin, less than an inch in length. Like the lump above it, it was tender. “It’s blocked. You should have come to me sooner.”

“I’m sorry.” You felt your ears drop, your leg relaxing a little in Alastor’s grip,

“That is quite the hangdog look you have.” Alastor’s smile grew thin, and he reached over to cup your cheek. “Fear not, I know a remedy.” His fingers lingered, tracing the grim line of your mouth. “It will be painful though, you think you can grin and bear it?”

Alastor always wanted a smile from you, but especially in difficult situations. You weren’t sure if it was sadism, a test, or some twisted beneficence on his part. “Of course,” you said.

“I will hold you to that, dearest,” said Alastor, raising your hoof to his lips. It was all you could do not to gasp when he ran his tongue between your two standing toes, laving the pad of each, a pleasurable but alien sensation. It made it easy to smile for him, and his eyes met yours, the corners creasing with approval. His hand cupped the back of your leg, the part that your brain still fuzzily equated to the arch of your foot, long fingers stroking the lines of the tendons. You had been intimate with him enough times that there was no terror for you in his teeth, only the disconcerting sensation of sharpness as he pressed his mouth to your spread toes, his lips a seal around your scent gland, and sucked.

To describe the sensation as pain was technically correct, but it would be like describing standing within a meter of a working jet engine as loud, or the sea as wet. It was a nerve pain, a primal sensation of wrongness. Pain conducted through the bones of your leg to your stomach and your spine, making you queasy and tearful all at once. But you had promised you would smile through this, so you fought for conscious control of your face, forcing your breathing into a slow, steady rhythm, pushing the tension that had collected in your shoulders down as you lay back in the bath, the corners of your mouth up. You spread the fingers of your hands over the lip of the bathtub, palms outward, arms trembling, and Alastor clasped one of your hands in his, squeezing.

Tears rolled hot down your face as Alastor continued, the sensation unrelenting, the only sound in the room your breathing and the low frequency hum from the lights above you. You were still smiling when Alastor’s thumb hooked around your leg, pressing into the cyst above your scent gland. More pain. A whimper in your throat that you could no longer suppress, the curve of your mouth a forced one. Alastor squeezed your hand tighter as he pushed, or perhaps you were squeezing his, and you felt movement in the gland, the inflamed tissue shifting as the blockage was pushed out. You sobbed once and it was gone, replaced by the sensation of pressure being released, Alastor’s tongue moving between your toes.

Alastor raised his mouth from your hoof, his eyes half-lidded and sultry. “You’re doing so well, darling,” he said, sweetly, and all of a sudden it was easy to smile again, his hand no longer in yours as he used both hands to handle and inspect your hoof. “Nearly done now.”

You peered at your hoof, the toes still splayed as Alastor massaged the cyst with his thumb. Your scent gland wept, oily yellow fluid spilling from it. It stank, an earthy, musky smell filling the room. Alastor could smell it- anything with a nose would be able to, and you felt heat rise to your cheeks as Alastor kept your leg firmly in hand. He had probably tasted it, too.

“Guess I should rinse that off,” you said, your smile turning wry as you wrinkled your nose, trying to hide the mix of horror and shame that you felt.

“Absolutely not,” said Alastor firmly, lowering his head to your hoof and lapping at the mess with his tongue, his breath hot between your toes. Fuck. Your stomach tightened at the sight of it, the noise of his tongue almost obscene in the quiet of the bathroom. It was disgusting and erotic all at once, Alastor’s eyes fixing yours with a fervid intensity as he breathed in your scent, and you found yourself hard, the throbbing pain that you’d felt moments before receding to arousal like a curtain revealing a stage.

If Alastor noticed your state, he chose not to acknowledge it, instead teasing the last of your scent from your gland with his mouth and his thumb and planting a soft kiss over the abused tissue; one that was painful by most people’s definitions of pain, but from him it was almost romantic, his lips the barest pressure. You knew better than to raise the matter- that would make him tease you, at best, leave you aching and unfulfilled. What Alastor gave was on his own terms.

“Incomparable, as ever,” Alastor murmured, as if what he had eaten had been drizzled across a plate in a Michelin starred restaurant and not licked fresh from between your toes. “You will come to me for these things in future, hm?”

“Is that a request?” you asked, a rough edge to your voice.

“Given your reaction, I don’t think it’s too tall an order, do you?” Alastor flashed his teeth, flirtatious and sinister all at once.

[johaerys-writes]

Chapter 3: El Diablo En El Ojo

Read on AO3 | Read from the beginning

The western wind is hot and humid as it sweeps over the valley, drifting in through the half open windows. It brings with it the the smell of warm, freshly tilled soil, of hay and manure, the lowing of the cattle and the clop of hooves from the round corral where the horses train. Achilles heaves a great sigh, letting his gaze stretch far across the yellow-blue afternoon sky. 

“Abscesses, as our trusty compendium puts it, are a collection of pus or purulent matter among the tissues of the body, and are a result of acute inflammation; occurring in a weak or scrofulous person, they may last indefinitely, in which case… Achilles, are you listening to me?” 

Achilles reluctantly tears his eyes from the window to look at his tutor. Chiron is frowning at him over the rim of his round reading glasses, Dr. Hippocrates' thick Compendium of Maladies and Formulae open on the table before him. Achilles straightens in his chair, trying to look invested, and doubting very much that he’s doing a good job at it. 

“Of course,” he says. “I’m all ears.” 

“Oh yes, and they’re everywhere but here.” Chiron, of course, doesn’t look convinced. “Will you indulge me, then, by reminding me how to treat an acute abscess, in advance of a doctor?” 

Achilles takes a breath, trying to jog his memory. “When it forms near the surface, a poultice with flaxseed meal or bread and milk is preferred. Open and drain the abscess as soon as pus has formed, and keep clean with castille soap and water.” 

“Correct. And what if there are indications that the abscess is not near the surface? If it’s in, let’s say, the brain?” 

“Why, then, I think our fellow’s a goner, Chiron,” Achilles quips with a grin.

Chiron doesn’t seem to share his amusement in the slightest; he shakes his head and lets out a long-suffering sigh as he takes off his glasses. 

“I wish you would take your instruction seriously every once in a while, Achilles,” he tells him, setting down his now folded glasses on the lace tablecloth, and closing the big tome. “We’ve been here for the better part of the afternoon, and I doubt that even a third of that information has made it into that brain of yours.” 

Achilles stretches his arms over his head with a groan and arches his aching back. Though the chairs in his father’s old study are quite comfortable, it still doesn’t make it any more enjoyable to spend most of his day cooped up in the stuffy room, when he could be outside, working or training or riding until both his own and Xanthus’ skin are damp with sweat and glistening. The large clock on the far wall idly ticks away the time, an insistent reminder of how slowly it passes when he’s studying, and how fast it flows when he’s anywhere but here.

It's not that he doesn’t enjoy his lessons with Chiron. He does, a great deal. Chiron is a renowned teacher, with vast knowledge on pretty much every subject imaginable. There is nothing under the sun, Achilles thinks, that Chiron isn't at least a little familiar with. Every day, Chiron teaches him maths and language and science and philosophy, but his teachings don't stop there: his tutor often takes him to the stables, the pens and the fields to show him how to harvest plants, how to treat wounded and sick animals, how to read the signs in the sky, the clouds, the birds, the stars. 

There is no other tutor that could teach as much, and so effectively. Achilles is well aware of how lucky he is. But today, with the merry sounds of the ranch coming through the window taunting him, he simply can't sit still. His mind is elsewhere, miles away—or perhaps just a quick hop and skip away, where the stables are, where Patroclus is.

The mere thought of the boy makes Achilles all giddy and flushed. He's probably hard at work just now, tending to the horses or cleaning the stalls, his shirt sleeves bunched up to his elbows and the sheen of sweat on the back of his neck. There is nothing Achilles craves more after a long day of studying or working than spending the rest of it with him, and he knows Patroclus feels the same. The bright smiles he gives him whenever he sees him are evidence enough, and although Achilles gets to see them everyday now, they still feel like a rare gift. It hasn't been too long since Patroclus regarded him with wariness after all, but over the course of the summer, something has changed. Achilles feels changed just by being around him.

Achilles' heart skips and thumps in his chest. It’s been happening more often of late that simply thinking of Patroclus makes something warm and fuzzy blossom in his chest. It’s thrilling, but it’s also scary in its potency. As much as he likes spending time with his other friends, never before has he felt such a visceral need for someone else’s company. 

His father’s words, however, are never far from his mind. 

In the Great War, after men got their first kill… this is what their eyes looked like.

Perhaps it is Patroclus himself that scares him, sometimes.

“Chiron,” Achilles says after a while. “Can I ask you something?” 

Chiron, who was flipping through the pages of the medical compendium again and muttering under his breath about poultices and grain-pills of Hepor Sulphur to help hasten suppuration, blinks up at him. “Yes, of course.” 

Achilles licks his lips, swallowing hard. He doesn’t know how to ask the question without sounding odd, so he just goes for it. “If someone kills another person… does that mean they’re a bad person?”

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