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Suggest Treatment For Itchy Red Spots On Right Leg

Posted on Wed, 17 Jun 2015

Question: Hello, I recently developed an unusual skin rash on my right leg (anterior mid quadricep area). It began while I was driving with my window rolled down, wearing shorts and sunlight hitting my lap (bare legs) after about 5 minutes of drive time I suddenly noticed a sensation of heat on both legs and looked down to see a few dozen, flat well-defined red petechial type spots (about 3mm diam) which were painless on the right leg. As soon as I blocked the sunlight the heat sensation abated and I forgot about the spots as I was busy unloading the vehicle. Later, in bed that night I noticed small raised wheals developing on the right leg that were extremely itchy, however the redness had diminished except that from my scratching. I chalked it up to a heat rash and tried to ignore it. The itching continued and developed into little blistered lesions (probably factitial?) And I waited for it to heal. Six days later it continues to heal though yesterday I was reclining on a patio near water, wearing sunscreen, long sleeves, pants and a hat. The sun was hitting my neck and last night I noted a single, large (this time about 6mm) flat, well-defined red spot near the jawline on the left side under my chin. It was asymptomatic except for the color. This morning there is a small firm swelling under it, with a fair bit of itching and the red color remains. It is one single lesion. I am a 47 y/o female, allergic to Amoxicillin, do not take any medications, have not eaten or drank anything unusual from my normal diet, and my health history is unremarkable for anything though my Rheumatoid factor was measured to be about 13.9 a couple years ago. I am not aware of any recent bug bites and have not found any ticks yet this season. The only notable preceeding event to my symptoms seems to be sun exposure. Any thoughts as to the condition I'm experiencing? If you could offer a differential diagnosis that would be much appreciated as I am not interested in seeking treatment for a likely benign, self resolving condition. I am a dentist and we make for terrible medical patients.

Answered by Dr. Goswami Debopom (9 hours later)

Brief Answer:
Not to worry. Let me help you out.

Detailed Answer:
Hello.
.
I have gone through the entire post . I can understand that you are a bit anxious about your health.
You, being a doctor, it would be easier for me to communicate with you.

Coming right to the differentials. It could be

1. Sunburn - UVB causes release of cytokines in skin resulting in pain, redness, erythema, edema.
2. Polymorphic light eruption(PMLE) - UVA is more responsible.kind of same treatment as sunburn with additional antihistamines will help.
3. Porphyria
4. Actinic dermatitis
5. Photosensitive lichenoid eruption

Skin disease are best diagnosed after a clinical examination. Since you do not wish to see a doctor right away, perhaps you can send a quality pictures of the affected region and I shall try narrowing down possibilities. There is a feature to upload pictures and reports on this page, you can utilize it.

Awaiting your response.

Regards

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Goswami Debopom (14 hours later)

Attached please find photo images of lesions
The brown spot is a lens scratch artifact

Answered by Dr. Goswami Debopom (28 minutes later)

Brief Answer:
Looks like sunburn. COloured photographs would have been better.

Detailed Answer:
The spots look like sunburn.

Coloured photographs would have helped more.

I would suggest you to -

- apply calamine lotion
- apply sunscreen while going out
- I would also start tablet Allegra .

Hope this helps.
Post any other question
Regards.

Above answer was peer-reviewed by : Dr. Neel Kudchadkar

Follow up: Dr. Goswami Debopom (46 minutes later)

Alright, thanks. The photos uploaded were color..not sure if they got converted to black & white by the website..?
Sadly, I have had multiple sunburns in the course of my life and never did any present like this...maybe this manifestation is part of aging.
Thank you for your opinion.

Answered by Dr. Goswami Debopom (5 minutes later)

Brief Answer:
you are welcome.

Detailed Answer:
Yes the pictures were black and white. Perhaps there were uploading issues.

If you do not have any further question, kindly close the thread.

Regards.

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. Vinay Bhardwaj