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Spots on my forearms and lower legs
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Spots on my forearms and lower legs

Ever since my late teens I have had spots all over my forearms and my lower legs. I am now 41 so they have been with me for over 20 years. My mom has the same problem and has had them for almost 50 years now. The best way to describe these spots are that they look like water spots - slightly whitish with a definite white border around the edges. As time goes by, the spots grow - but very very slowly. They started out as small 1-2mm spots and over 20 years have grown to be about 8-10mm in diameter. It seems to me that new spots have appeared over time and are now appearing on my upper legs and the back of my upper arms. The older spots are now getting red and ugly - probably due to years of me scratching and picking at them. I have never ever seen a spot go away.

These spots do not itch. The do not affect hair growth. They do no bleed or weep in any way. They are rough to the touch, possibly due to scarring, but are not lumps at all. The only appear on the top of my forearms, there are none on the underside. The sun has no effect on them and they don't vary with time, stress, temperature or anything. Other than these spots, I think my skin is in pretty good condition for my age - not a lot of sun damage.

I went to see a dermatologist and he seem preoccupied with the effects of the scarring. I tried and tried to get him to notice the undelying problem with the white spots but he didn't seem to have the time.

He expalined the redness as being due to me picking at my skin - probably due to stress. I understand that - but the root problem is not stress, it is these horrid white spots all over me. He explained the spots on my legs as being entirely different and due to blocked hair follicles, but the spots are exactly the same as the spots on my arms. And the spots do not correspond to hair follicles at all.

He said they were not viral, bacterial, fungal, or cancerous. They were not eczema or psoriasis.

What are these spots? Other than my mom, I have never seen anyone else with them ever. I look at other peoples forearms all the time and have never seen this before. For 20 years I have been looking in books and on then on the Internet and have never found any condition that this resembles. And it bugs me so much...
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242489_tn?1210500813
Obviously, I can't tell you what you have without seeing you, but I can make an educated guess.  I don't think you have an underlying disease.  (I don't know of one that matches your description.)  I think you have white spots from chronic trauma from picking.  (I do see that often.)  I think that's what the dermatologist you saw thought too.  I think the fact that he couldn't see what you were trying to show him  had nothing to do with not having time.

I don't expect you will find my opinion satisfactory; perhaps you will conclude that I too am not taking your complaint seriously.  However, you should at least consider its validity.  If I am right, then the kind of And of course you are free to get another opinion in person, doctor you should be seeing is a psychiatrist specializing in obsessive-compulsive disorder.  

You can of course get another opinion in person.  If you do, you must absolutely not pick your skin for at least a month, so there will be no confusing changes.

Best.

Dr. Rockoff
13 Comments
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Avatar_n_tn
I wish I hadn't brought up the picking part. That explains the redness around the oldest dozen spots on my forearms. That I understand and appreciate that I should not do it. Its not obsessive-compulsive behavior, its frustration with a problem that just won't ever go away. People are always asking me what is wrong with my skin and that is embarrassing.

What concerns me is the underlying problem. I have hundreds and hundreds of white spots all over my arms and legs. If I look at my legs very closely, I can see hundreds of very small spots starting - and I know what those will eventually result in. It looks like I got wet in the rain and the spots left lime rings all over me. My mother has the same problem and my sister, to a much lesser degree as well.

(Interestingly, my mom went on thyroid medication a couple years ago and the problem cleared up until they reduced her medication and the problem returned)
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242489_tn?1210500813
In that case, I simply don't know what you have.  I suggest you consult a dermatologist at an academic medical center near you, perhaps one who has a special interest in pigment disorders.  Even if such a specialist is not available, however, a biopsy or two may be helpful, and can be sent around to specialists in other cities.  I suggest that your mother and sister be evaluated at the same time.  You should also bring photographs of the rungs that you can see on your skin when it rains.

Dr. Rockoff
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Avatar_n_tn
I think my guilt reflex kicked in. When the dermatologist told me that the redness was due to picking, I agreed. I spent the weekend trying to stop the habit and discovered it isn't a habit. I don't pick at them at all. I checked with my mom and she was adament she doesn't either. The redness comes over time. As the spots grow, they join together with others to becomer larger areas that get red. I almost wonder if the redness is due to the skin thickness being reduced. I have noticed that the larger areas look like something looks after acid etching. There is a white thin well defined border around the sponts and the center is lower down (very minutely so) than my normal skin. The redness increases towards the center of where each spot is.

I am going to see if I can find someone with more experience. When I got the prescription filled at the pharmacy, a woman at the counter asked me if I was happy with the local dermatologist I had seen as she had also seen him and she was frustrated that he didn't listen to her.

BTW, I looked up "white spots" on this forum and found another question back in 1999 by someone named Rick. He described almost the exact same problem. He had wondered if his spots were the result of chicken pox.
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Avatar_n_tn
Disseminated superficial actinic porokeratosis - the pictures I have found are exactly what I have. And it is genetic.
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242489_tn?1210500813
That might make sense.  I would think the the doctor you saw would have seen these spots when you consulted him.  Also, DSAP (as it is known) usually has a fine scale around the edges, rather than just white spots.  A textbook describes the lesions as, "keratotic papules ranging from 2 to 5 mm in diameter; they are often pink in color."  "Keratotic" means scaly.   A skin biopsy would make the diagnosis one way or another.  There isn't much available in the way of effective treatment, however.

Dr. Rockoff
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Avatar_n_tn
I have been looking up images all over the web and they all look like what I have. I don't have it as badly as most of the images though, but the appearance of the milder spots are exactly what I have. My spots have started out as a lighter color than my skin, but over the years have progressed to red. The thready border is exactly the same.

Although there is no effective treatment, I am quite relieved. I have searched for years for some idea what this is. I have looked at images of so many conditions and they never ever looked the same as I have. Actinic keratosis, superficial basal cell carcinoma, fungal infections, and on and on. I could never convince myself I had any of these conditions.

Apparently the dermatologist I saw wasn't a doctor, but was a "PA" ??

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Avatar_n_tn
My mother and I share the same (DSAP) skin disease that you do - although she developed hers when she was in her 40s and I was lucky enough to get mine when I was 20!  My condition is getting progressively worse and increasingly embarrassing.  I have tried the Retin-a/Efudex combo routine, but it basically burned my skin, and seemingly made my skin even more sensitive to air and sunlight, so that the number of spots has quadroupled since the treatment 1.5 years ago.

I wonder whether stress might play a role in the condition.  I have not seen that on any web sites, but my condition was exacerbated after I broke my arm and had it in a cast for 4 weeks (no sunlight exposure).  When the arm came out of the cast, the spots seemed to be even worse - yet they had had absolutely no sunlight!

I also wonder whether there is any sort of holistic remedy for this genetic disease.  I noticed a listing of Vitamin D topical remedies - might calcium be a possibility?

Have you had any luck with "natural" treatments?  At one point, I was applying cover up all over my legs, but it really did nothing.

Know that you are not alone!
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Avatar_n_tn
hi i'm not sure if i have the same problem, but i think we're on the same page. like you, i have these weird spots on my legs; it's hard to describe, but they look like small brown scabs. I can pick on it and remove it (which would release a hair follicle) but that would not solve the problem, because even if i do pick on it, it would become red and another scablike growth would emerge anyway.

For a long time now, i've always believed that it was varicose eczema, but now i've come to doubt that very highly, because it's not itchy at all. It's just there, looking horrendously ugly. I looked up some of the terms you mentioned, but none of the descriptions on the pages apply to me. It's not psoriasis because it's not itchy at all.

By the way, i've been diagnosed with atopic eczema since i was a kid. (i'm 24 now) My dermatologist was the one who told me that the weird spots on my legs were a result of eczema. But, nothing she prescribed helped in curing it or even lessening it.

i've tried searching everywhere in the web about my condition (and hopefully, for a cure) but to no avail. i hope someone can help me ....
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Avatar_n_tn
I think what you may have is porokeratosis. Im 14 years old and ive had linear porokeratosis since i was 18 months old. Linear porokeratosis means that the spots arrange themselves in a line, in my case, up my left leg from my toes up to my thighs. My mum took me when i was younger to a few doctors and none could tell what it was except one, and even he didnt know much about it. Ive tried lots of medicines, including a cream (ive forgotten the name of it) that you have to put on with gloves and only on the skin affected. Ive also tried putting a type of fruit on my skin over night. Nothing has worked. I have the tiny white spots all over my arms and legs too. My mum has porokeratosis too, but she only has tiny patches on her legs and a few white spots too. My dad and sister dont have it at all. The porokeratosis is in tiny spots on my toes at first, and when it gets to the back of my leg, it comes in huge red patches and then goes back to small spots when it gets to the back of my thigh. I understand how embarrassing it is. I dont like to wear shorts or skirts, because i dont like people seeing my leg and asking questions. You should stay out of the sun. The sun make the patches get bigger and apparently porokeratosis patches are prone to skin cancer too. Because there isnt a cure, i just stay out of the sun and put lots of mosturizer on my leg. Mosturizer improves the appearance a lot for me. Ive never met anyone with porokeratosis before either. Im sure there are lots of people out there somewhere though. I hope i helped you a little :) ~Abigail
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Avatar_n_tn
Hi I am not a doctor, but I too have been getting brown AND white spots everywhere except for my legs but I do not have any redness. I been doing research and I think I may have "TINEA VERSICOLOR" (sun spots). You can look at this website for pictures if you think you may have this: http://orlandoskindoc.com/tinea_versicolor.htm

PLEASE NOTE: Although that website is an advertisement, I have not tried their products and do not promise they will work.

This summer is the first time when I been tanning out in the sun, and thats when I started noticing the spots. Although its odd because I have dark dry spots everywhere else but on the inside of my elbows I started getting white spots. I also been noticing is when I take HOT showers and using a generic brand soap are when the dark spots appear most. So lately, I been cleansing my skin with cetaphil moisturizing facial soap and taking cold showers (although I know that will be hard in cold weather).

I also been using an anti-fungal cream prescribed by my doctor called NYSTATIN & TRIAMCINOLONE ACETONIDE. After a week I noticed the the dark spots were disappearing. As for my white spots on my arms, I think they will just have to even out naturally because I'm very tan. And I read they will disappear in the winter time, atleast thats what I'm hoping. I've also read that if you are pregnant you have a greater chance of getting sun spots such as your face due to the sun. Anyhow, I hope this info has been useful to anyone out there. Good luck guys.
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Avatar_n_tn
Hi I am not a doctor, but I too have been getting brown AND white spots everywhere except for my legs but I do not have any redness. I been doing research and I think I may have "TINEA VERSICOLOR" (sun spots). You can look at this website for pictures if you think you may have this: http://orlandoskindoc.com/tinea_versicolor.htm

PLEASE NOTE: Although that website is an advertisement, I have not tried their products and do not promise they will work.

This summer is the first time when I been tanning out in the sun, and thats when I started noticing the spots. Although its odd because I have dark dry spots everywhere else but on the inside of my elbows I started getting white spots. I also been noticing is when I take HOT showers and using a generic brand soap are when the dark spots appear most. So lately, I been cleansing my skin with cetaphil moisturizing facial soap and taking cold showers (although I know that will be hard in cold weather).

I also been using an anti-fungal cream prescribed by my doctor called NYSTATIN & TRIAMCINOLONE ACETONIDE. After a week I noticed the the dark spots were disappearing. As for my white spots on my arms, I think they will just have to even out naturally because I'm very tan. And I read they will disappear in the winter time, atleast thats what I'm hoping. I've also read that if you are pregnant you have a greater chance of getting sun spots such as your face due to the sun. Anyhow, I hope this info has been useful to anyone out there. Good luck guys.
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Avatar_n_tn
Hi I am not a doctor, but I too have been getting brown AND white spots everywhere except for my legs but I do not have any redness. I been doing research and I think I may have "TINEA VERSICOLOR" (sun spots). You can look at this website for pictures if you think you may have this: http://orlandoskindoc.com/tinea_versicolor.htm

PLEASE NOTE: Although that website is an advertisement, I have not tried their products and do not promise they will work.

This summer is the first time when I been tanning out in the sun, and thats when I started noticing the spots. Although its odd because I have dark dry spots everywhere else but on the inside of my elbows I started getting white spots. I also been noticing is when I take HOT showers and using a generic brand soap are when the dark spots appear most. So lately, I been cleansing my skin with cetaphil moisturizing facial soap and taking cold showers (although I know that will be hard in cold weather).

I also been using an anti-fungal cream prescribed by my doctor called NYSTATIN & TRIAMCINOLONE ACETONIDE. After a week I noticed the the dark spots were disappearing. As for my white spots on my arms, I think they will just have to even out naturally because I'm very tan. And I read they will disappear in the winter time, atleast thats what I'm hoping. I've also read that if you are pregnant you have a greater chance of getting sun spots such as your face due to the sun. Anyhow, I hope this info has been useful to anyone out there. Good luck guys.
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Avatar_n_tn
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Avatar_f_tn
A related discussion, White spots on legs was started.
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Avatar_f_tn
I am 16 years old and I have these dark spots on my legs and arms. I have had them since I van remember but they only got worse as I became a teenager I have no self esteem and am always worried people will see my legs and arms I always cover up and even find it difficult to go to parties or even swim.
When I scratch them the hair follicle appears and it becomes red and reappers. I have been too embarrassed to go to a doctor.
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Avatar_f_tn
And because I am of African descent they are dark and not white but nonetheless show as my skin colour is lighter than spots
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