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Q. I need a second opinion for my skin pigmentation.

Answered by
Dr. Rakesh Kumar Bahunuthula
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Nov 14, 2016 and last reviewed on: Nov 02, 2020

Hi doctor,

I am seeking a second opinion on an issue. Recently, a doctor at a skin cancer clinic observed my hands and arms and noticed sunspots on my hands. I have something similar on my right inner forearm. In the past, I have noticed a spot growing adjacent to this. Another, dermatologist felt this was due to the lotions I have been using. I do have sensitive skin prone to rashes and breakouts and so, he recommended to stop using lotions. What is your opinion here?

#

Hi,

Welcome to icliniq.com.

  • Blotchy pigmentation is a common problem noticed in patients above 50 years of age. A sensitive skin predisposes more to such pigmentary changes.
  • Although, commonly seen in chronically sun exposed sites, they do tend to occur elsewhere as a part of dermatoheliosis (chronological photoaging of the skin).
  • As your skin has had repeated rashes and breakouts in view of its higher sensitivity, it would be preferable not to apply occlusive cosmetics and lotions as they may further increase the risk of such pigmentary lesions.
  • You could instead use a sunscreen with SPF of more than 30 (sun protection factor) and a good moisturizer to prevent further such lesions.
  • You can be assured that the lesions have no features suggestive of any skin malignancy.

Differential diagnosis:

1. Macular seborrheic keratosis.
2. Solar lentigo.
3. Elastosis secondary to aging.
4. Stellate pseudoscars and pigmentation of aging

Treatment plan:

Sunscreen with SPF greater than 30 in the morning and good moisturizing lotion at evenings.

Preventive measures:

1. Avoid occlusive cosmetics.
2. Consume vitamin C rich foods.

Regarding follow up:

For further information consult a dermatologist online.---> https://www.icliniq.com/ask-a-doctor-online/dermatologist

Hi doctor,

Thank you for your answer and will follow your advice. Could I ask your opinion on another lesion? My doctor did have a look at this recently as a small bump appeared on it. She felt it was a pimple. This is on my foot and it does not itch.

#

Hi,

Welcome back to icliniq.com.

  • It is quite uncommon to have a pimple on the legs and feet as they are not the oily parts of the body.
  • It is unfortunate that I cannot make out much from your image. Kindly upload a better image, both long and close up views, so that I could help you out.
  • Please mention the duration of the lesion and if there was any preceding insect bite.

Revert back with the photos to a dermatologist online --> https://www.icliniq.com/ask-a-doctor-online/dermatologist

Hi doctor,

Yes, I will send the photos. The lesion was similar to sunspot that had been on my foot for some time. Now, the pimple has flattened. The redness to the side has just happened, maybe from aggravating it.

#

Hi,

Welcome back to icliniq.com.

  • The clinical image of your lesion is suggestive of an inflammatory benign papule.
  • The sunspots may at times show such inflammatory changes, especially when irritated by sudden sun exposure or other contacts.
  • Cherry angioma, a small vascular lesion, is also a possibility considering your age.
  • As you have previously mentioned that you have a pretty sensitive skin, even an insect bite, allergy to new footwear or early eczematous lesion can mimic the same.
  • There are no changes suggestive of any malignancy in the image. I would advise you to relax and follow the necessary precautions.

Differential diagnosis:

1) Papular urticaria.
2) Inflammatory solar lentigo.
3) Insect bite hypersensitivity.
4) Cherry angioma.

Treatment plan:

Tacroz 0.1% cream (Tacrolimus) for local application at night for one week.

Preventive measures:

1. Avoid new footwear.
2. Use socks regularly.
3. Make sure no insect bites.

Regarding follow up:

For further information consult a dermatologist online.---> https://www.icliniq.com/ask-a-doctor-online/dermatologist

Thank you doctor,

That is a relief.

#

Hi,

Welcome back to icliniq.com.

You are welcome. Do not hesitate to contact us for more doubts.

For further information consult a dermatologist online --> https://www.icliniq.com/ask-a-doctor-online/dermatologist


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