Brief Answer: Hello . Thank you for your question. Detailed Answer: I would be pleased to assist you with your problem. I can understand how miserable you might be feeling without a diagnosis . From your history it indicates to me that you have Porokeratosis in which one sees circular bumps with sometimes a hard keratin like material in the centre. This is caused by certain risk factors that include genetic inheritance, ultraviolet light exposure, and immunosuppression. It develops slowly and expands over the years. Protection from the sun, use of emollients, and watchful observation for signs of malignant degeneration may be all that is needed for many patients. If lesions are widespread and medical treatment is desired, several medications have potential benefit. These include: Topical 5-fluorouracil Treatment must be continued until a brisk inflammatory reaction is obtained. Recurrences may be seen. Topical vitamin D-3 analogues Both calcipotriol and tacalcitol have been shown to be effective after 3-6 months of treatment . Immunomodulators Topical imiquimod cream has been shown to be effective. Topical retinoids Topically applied retinoids (tretinoin, tazarotene) may be beneficial for improving the abnormality in keratinization that causes cornoid lamellation, thereby reducing the hyperkeratosis. Please note that these treatments will need a prescription from your Doctor. Thanks and Take care

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