hyperpigmented skin

A bunch of red (non-itchy or irritated) spots appeared rather quickly under my breasts and around my waist a few months ago. It took so long to get an appointement with the dermatologist that the spots have turned brown now and look like scars to me. I really hope they aren't scars. The dermatologist said that he really couldnt diagnose the problem because the spots didnt seem to be "active". He says he sees no reason to believe they are scars and that they should just go away but its been a couple months now and they dont seem to be going away. I would really just like to know at least what this is because i feel like it might be an internal disorder of some sort manifesting dermatologically. But all of my lab work is good. I do have some abdominal pain that the doc's assume is acid reflux. Any help would be greatly appreciated. I will try to upload some photos of the red spots a few months ago and the brown spots now.

[Bhupinder Kaur, MD]

Hello,
I cannot confirm anything without examination but it can be erythrasma. Erythrasma is a chronic superficial infection of the intertriginous areas of the skin and the typical appearance is well-demarcated, brown-red macular patches. The skin has a wrinkled appearance with fine scales.

It has to be differentiated from contact dermatitis,psoriasis,sweat dermatitis and fungal infections which may mimic it.Wood lamp examination and gram staining are the tests for its diagnosis.So nothing can be confirmed without examination.

The standard therapy of erythrasma is antibiotics and antifungals because it is caused by a bacteria C minutissimum.Erythromycin is the drug of choice.Mild steroids are helpful in reducing the inflammation associated with it. But use it only after a dermatologist’s prescription.

Hope it helps.Take care and pls do keep me posted on how you are doing or if you have any additional doubts.Kind regards.