Why have I had a raised mark on my forearm for a month?

Question

Hello doctor,

I have noticed a raised mark on my forearm. I am not sure what it is. It has been there for a month. At some point, I did burn myself, but I do not recall the mark of the burn, so it is either that or something else. I am including photos of it when I noticed it at first, and then a photo of it one month later.

Is it a burn mark or something more concerning?
Should I go see a dermatologist in person?

Kindly help.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

I can see the pigmentation (attachment removed to protect the patient’s identity) that has increased in size and severity in the area where there is no tattooing. Most probably, it seems to be lichen planus pigmentosus or post-inflammatory hyperpigmentation.

Based on the images and your history, the lesion appears as an ill-defined hyperpigmented patch without obvious scaling, ulceration, or active inflammation.

While a prior burn can leave behind post-inflammatory pigmentation, such marks are usually flat and gradually fade over time. The persistence for one month with slight elevation makes a simple burn mark less likely.

One possible consideration is lichen planus pigmentosus, which can present as dark, patchy pigmentation over the forearms and may be subtle in early stages. However, other differentials include post-inflammatory hyperpigmentation, frictional melanosis (from the watch strap), or early localized dermatitis.

At present, there are no obvious alarming signs like rapid growth, ulceration, bleeding, or irregular borders suggestive of malignancy.

I would suggest the following:

Avoid friction or pressure from the watch in that area. You can change the watch strap type.
Use a mild moisturizer regularly.
Apply sunscreen to the lesion.
A mid-potent steroid, like Betamethasone cream, can be started if available.

You should visit a local dermatologist so that various evaluations, like dermoscopy and skin biopsy (although not needed), can be done. For a definitive diagnosis and targeted treatment, a direct consultation would be more appropriate.

I hope you are satisfied with my answer. For further queries, you can consult me at iCliniq.

Thank you.