AK? Eczema? Something else? (Picture attached)

I have attached a picture of the skin area in question on the back of my hand. There are two smaller but similar patches in addition to the one in the picture. All together, the one in the picture and a smaller one are on my right hand. Another similar but smaller patch is on my left hand. When they first developed, they were itchy, but they aren't as I'm writing this. They are certainly dry and have grown a bit over the past few days. The main one developed about two weeks ago. I have an appointment with my dermatologist in three weeks (soonest I could get) and after sufficiently freaking myself out with WebMD and other sites, that seems like a long time to wait for an answer. Any thoughts on what it might be? AK? Eczema or dermatitis of some sort?

Some background information:
I am not a big sun person, though I do have fair skin, light brown hair and blue eyes (which all came up in AK literature). I don't live in a warm weather climate (Ohio and Indiana most of my life, Colorado for 4 years). I've never had a job that involved working outdoors. I'm 25. I have a history of hay fever (which was a factor for something else I researched but can't recall). I haven't come in contact with any chemicals that I know about. I'll be glad to provide more information if it would be helpful. I know it doesn't take much sun exposure to cause things like AKs, but I've been a pretty indoors person from a very young age. Any help would be immensely appreciated.

[BhumikaMD]

Hi,

It is difficult to say what this could be. Perhaps the differentials you provided are correct and close. This appears to be dermatitis, perhaps keratosis. The cause of this could be , solar, allergic, seborrheic, or perhaps any other cause. This will be elucidated based on the history, examination or tests including biopsy. Treatment options for many of these are similar and therefore a visit to the doctor can most definitely help you take some decision on the treatment.

It will be best that you avoid sun as you have already said. Further use some medicated sun-screen and moisturizers as required to help in this.

Please tell us more about the history and keep us posted on your health and what your dermatologist says.

all the best.

[ThatDamnDave]

First of all, thank you so much for taking the time to answer my question. There are a ton of questions here, so I definitely appreciate it. I know that a real diagnosis will only come after a visit and examination, but I was looking for a bit of guidance and you gave me that, so thank you.

Medicated sunscreen is not something that I had thought of, but perhaps that would be a good thing to apply until my visit? Would it be worth seeing my general physician (as I know I can get in well before May 9) or would that be a waste if I'm already going to a dermatologist May 9.

As far as history, I have had two sebaceous cysts, one of them is getting cut out at that May 9 appointment. It is in the back of my neck and was drained once before but the capsule was not removed. It filled back up and became infected. I went to my dermatologist and we set up the May 9 date to have it removed. It has since returned to "normal" after some antibiotics, but I think it'll be taken out anyway just so I don't have to worry about it anymore. The second is directly above where my ear meets my head and has been about the size of a BB since I first noticed it, perhaps 7-8 months ago.

I have no idea if this kind of history is relevant. I have no other medical traits other than hay fever (which has been worse this year than normal). I have had a slight dandruff problem throughout my life, but nothing that wasn't taken care of with dandruff shampoo. I had a mole removed around the age of 12 simply because it was on my face and a distraction.

I'm not sure what else to put as far as history. The cyst is really the only major medical event in my life. Once again, thanks so much for your time and any further insight would be very much appreciated. My key questions at this point would be a) does anything in my extended history suggest a particular diagnosis and b) would scheduling a general practitioner appointment be useful or would he just send me to a dermatologist anyway?

Thanks very much.

[ThatDamnDave]

As a minor update, I scheduled an appointment with my general physician just to make myself feel better about getting it checked out promptly, but my questions above remain. Thanks again.

[ThatDamnDave]

Just bump to get some more feedback.

[BhumikaMD]

Hi,

Well from the history that you mentioned here, hay fever is the one that finds my attention, Since that would indicate that there is some kind of allergic/sensitivity to external stimuli. Hence, I would keep Allergic Dermatitis on top of my differential as of now.

Nevertheless, it is clear that a dermatologist is the right clinician to visit now. A GP would refer you to a dermatologist anyhow.You should get a medicated sun-screen for yourself.

I am glad that we are able to ease your anxiety a bit. Please keep us updated.

Best regards

[ThatDamnDave]

Great. Thanks very much for the information. Here's hoping it's allergic dermatitis and not an AK. Thanks for taking the time to help people in this forum, including myself.

[BhumikaMD]

Hi,

Glad the post was of help to you and thanks for the kind, encouraging words.

Do keep us posted about how you are doing and if you need any further information.

Regards.