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Brown bruise type marks on one arm

My thirteen year old daughter visited the dermatologist to have a punch biopsy on her right arm for a series of bruise type marks extending from her shoulder to her elbow.  She has had two or three of these marks near her shoulder for over a year, but they seemed to have a period where they multiplied a few months ago. There are about eight now, and they have not faded.  She refused the biopsy (was very upset), and the doctor said he wasn't terribly concerned- that it could be one of two things-neither of which was too serious.  He also said that they were not particularly treatable.  
The fact that it was only on one arm suggested to him that it might have been a result of some trauma causing a permanent pigment change. We can't, however, think of anything of that nature which has happened. What might be the causes of the discoloration and is there anything that could fade them?
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242489 tn?1210500813
I agree with the dermatologist that the one-sided nature of the spots suggests external trauma.  The fact that you can't think of any doesn't help or hurt--most of us can't recall what produced a bump or bruise.

I aslo agree with his that the only way to at least try to ascertain the exact nature of the spost (and treat them) is to perform a bippsy.  If your daughter refuses, so be it--perhaps nothing useful would come from it, and if the dermatologist doesn't think it's risky to let things be, then I agree with him there too.

But beyond getting another live opinion, I'm afraid I don't have any other diagnostic or therapeutic suggestions.


Dr. Rockoff
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