Cellulitis: The patient presents with cellulitis on the arm, which is a common bacterial skin infection that can occur after a bug bite or other skin break. The recent rash on the legs could be a separate bug bite, and the cellulitis could be a secondary infection.

Lyme Disease: Although the patient did not develop erythema migrans, it's still possible to have Lyme disease, especially if the tick was attached for an extended period. However, the 1-hour attachment time is relatively short, making this less likely.
Southern Tick-Associated Rash Illness (STARI): This condition is characterized by a rash similar to erythema migrans but is not caused by the Lyme disease bacterium. It's possible that the patient has STARI, especially if the tick was from a region where this condition is common.
Folliculitis or Impetigo: The rash on the legs could be a separate skin infection, such as folliculitis or impetigo, which can occur after a bug bite or other skin irritation.

Rocky Mountain Spotted Fever (RMSF): This is a potentially life-threatening disease that can be transmitted by tick bites. Although the patient did not develop the characteristic rash, RMSF should be considered, especially if the patient has a fever, headache, or other systemic symptoms.
Ehrlichiosis or Anaplasmosis: These are tick-borne illnesses that can cause fever, headache, and other systemic symptoms. They can be severe and even life-threatening if not treated promptly.
Babesiosis: This is a parasitic disease that can be transmitted by tick bites. Although it's relatively rare, it can be severe, especially in immunocompromised patients.

Tularemia: This is a rare bacterial disease that can be transmitted by tick bites. It can cause a range of symptoms, including skin ulcers, fever, and pneumonia.
Tick-Borne Relapsing Fever (TBRF): This is a rare disease that can be transmitted by tick bites. It's characterized by recurring episodes of fever, headache, and other systemic symptoms.