Erythema and nonpitting edema often surround the vesicle. Initially, the vesicular fluid is serous and contains large numbers of organisms. Despite the erythema and swelling, lesions are not painful but may be mildly pruritic. Lymphangitis, lymphadenopathy, fever, and malaise may accompany the skin infection. After one to two weeks, the skin lesion dries and a permanent scar is formed.
Lesions occur primarily on exposed regions of the body.
A single lesion usually occurs, although occasionally, multiple sites may occur as a result of simultaneous inoculations. Inhalation anthrax is biphasic in its presentation. Occasionally, the sensation of chest heaviness has been reported. Rhonchi may be heard on examination. Within two to four days, symptoms temporarily resolve but are rapidly followed by the second, more severe stage of the disease.