I have flat red dots on my feet, ankles, and leg, which fade and come back. Please help.

Question

Hi doctor,

I have some flat red dots on my feet, ankles, and leg. They are petechiae because they do not blanch. I do not have many of them, but they always tend to fade and come back in the same spots. I do not know if it is normal. I consulted five doctors, and I have not got my blood tested. They do not think it is worrisome. I would like to get another opinion. Thank you.

Answer 1

Hi,

Welcome to icliniq.com.

I understand your concern. Please attach photographs to suggest the diagnosis and treatment. It might be pigmented purpuric dermatosis, a kind of pigmentation due to vascular stasis, seen on the lower legs and around ankles, but I need to see it to confirm. Kindly send a picture of the affected area to assess the condition and suggest the appropriate diagnosis and treatment. Take care.

Answer 2

Hi,

Welcome back to icliniq.com.

Thanks for sharing the pictures (attachments removed to protect the patient's identity). It is pigmented purpuric dermatosis, albeit a very mild one. This condition is also known as capillaritis. There is dilation of blood vessels, which leads to oozing of blood cells out of the vessels in skin tissue, causing purpuric lesions and pigmentation. There are many causative factors. A few of them are increased vascular pressure due to prolonged sitting or standing, aerobic exercise, etc. Also, alcohol intake and some contact allergens are implicated. You can use the following medications for not more than three weeks, Mometasone cream and Cetaphil cream, a moisturizer. Mix both in a 1:1 ratio and apply twice a day. Also, take a break if you have to stand or sit for long. You can put a pillow beneath the legs during the night to elevate them to reduce venous pressure. Follow up after three weeks. This condition is usually harmless and chronic. Nothing too serious about it, as told by other doctors too. Take care.

Answer 3

Hi,

Welcome back to icliniq.com.

You need not worry. It is not leukemia for sure. Avoid any precipitating factors, if any, as I mentioned earlier. And follow the advice. Take care.

Answer 4

Hi,

Welcome back to icliniq.com.

I understand that you are worried. But seeing photographs does not always cover the entire spectrum of clinical conditions. If one has to make a diagnosis clinically in your case, it is pigmented purpuric dermatosis due to classic sites and lesions. Leukemia cutis can have a varied presentation and can present on limbs but have prominent raised papules or nodules and more conspicuous and broader distribution. They do not come and go, as yours do. That is why no doctor has ordered any blood work in your case. Still, I understand your concern. If it is bothering you this much, I recommend you ask for blood work and skin biopsy, citing your anxiety. But clinically, it is implausible that it is leukemia cutis. Take care.

Answer 5

Hi,

Welcome back to icliniq.com.

You are right. If I or any dermatologist had suspected leukemia, we would have ordered atleast a routine blood count. Other systemic symptoms also accompany most of the cases. Just use some moisturizer and a bit of leg end elevation while sleeping and relax. It is improbable for this variant of pigmented purpuric dermatosis to progress. Keep observing. Take care.