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Hello, I Need Reassurance. I Have Bad Health Anxiety And

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Posted on Wed, 9 Sep 2020
Question: Hello, I need reassurance. I have bad health anxiety and I'm scared I may have peutz-jeghers syndrome. I have a brown labial macule since childhood and a few macules scattered across my pubic/anal area (medium to light brown). However I never had fingers/foot/inner mouth macules. I also underwent a couple abdominal ct scans (with and without contrast) + an upper endoscopy combined with a colonoscopy at age 24 (to investigate diarrhea and cramping, i'm 28 now with IBS and Hashimoto's otherwise healthy female) that showed absolutely no polyps. My dermatologist tells me my spots are not Peutz-jeghers' at all and that I should relax. Should I specifically ask for a jejunum screening or am I clear ? I guess if there have been any polyp linked to this disease it should have showed up by age 24 ?Thanks for your insight.
doctor
Answered by Dr. Asmeet Kaur Sawhney (1 hour later)
Brief Answer:
No need of jejunal biopsy

Detailed Answer:
Hi
Welcome to ask a doctor service
I have gone through your query and understand your concern.
I don’t think you have peutz-jeggers syndrome.
A single lip macule doesn’t indicate that you have this syndrome.
Also you don’t have the classical macules seen around the oral cavity, lips and fingers and your CT Scan report was fine.
There is no need to go for jejunal biopsy.
Don’t worry and relax.
Regards
Dr Asmeet
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Asmeet Kaur Sawhney (1 hour later)
Thanks for answering, Dr Asmeet

Can those macules be a simple feature without an associated syndrome then ?
I also have 3 cafe au lait spots on the right side of my body (right knee, right hip and right buttock, there are pale and a bit irregular). Most people on my maternal side exhibit a cafe au lait spot including my mother, aunt and uncle, and my mother has intensive body freckling.

My maternal grandmother died of cancer in her 60's (unknown cancer type since it was found too late to track back its primary source) but otherwise there's no malignancy history in my family.

I have between 7-9 XXXXXXX tiny spots/lentigines around my pubis (mostly on the mons pubis and a couple near my labia), two around the anal verge, and only one on my face (lower lip vermillion) + freckling mostly on the right side of my body (right arm and right knee, there is one cafe au lait spot on that exact knee)

Does it make you think of a syndrome in particular or is it just an unique pigmentation ?

I underwent the following (clear) health exams also :
-clear brain MRI
-clear spinal x-ray save for a very mild scoliosis
-clear chest x-ray
-clear abdominal ultrasounds
-clear pelvic ultrasounds
-clear breasts ultrasound

I guess if anything was wrong it would have been noticed during childhood but I'm wondering why I'm exhibiting all those cutaneous features. I was thinking about Cowden and XXXXXXX Complex but except for my skin there is nothing that matches perfectly.

Thank you for your professional opinion.
doctor
Answered by Dr. Asmeet Kaur Sawhney (24 minutes later)
Brief Answer:
Welcome

Detailed Answer:
According to your complaints these macules and cafe au lait macules seems to be an isolated finding and not an indicator of any malignancy or syndrome .
You seem to be having a family history of cafe au lait macules and freckles.
Nothing to worry about as these are isolated findings and you don’t have any symptoms.
Note: Hope the answers resolves your concerns, however for further guidance of skin related queries consult our Dermatologist.Click here to book a consultation

Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
Answered by
Dr.
Dr. Asmeet Kaur Sawhney

Dermatologist

Practicing since :2007

Answered : 4993 Questions

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Hello, I Need Reassurance. I Have Bad Health Anxiety And

Brief Answer: No need of jejunal biopsy Detailed Answer: Hi Welcome to ask a doctor service I have gone through your query and understand your concern. I don’t think you have peutz-jeggers syndrome. A single lip macule doesn’t indicate that you have this syndrome. Also you don’t have the classical macules seen around the oral cavity, lips and fingers and your CT Scan report was fine. There is no need to go for jejunal biopsy. Don’t worry and relax. Regards Dr Asmeet